Zhu Ting, Ding Fangyuan, Chen Rui, Kang Haoyang, Guo Rui, Wu Xiaoming, Jiang Dong
Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing, 100191, China.
Beijing Key Laboratory of Sports Injuries, Beijing, 100191, China.
J Orthop Surg Res. 2025 Apr 7;20(1):350. doi: 10.1186/s13018-025-05751-x.
Medial meniscus (MM) injuries are common and often contribute to knee osteoarthritis (KOA). While studies focus on joint degeneration, the role of extrinsic factors such as postural control remains underexplored. This study investigated how MM injuries affected postural control, particularly plantar pressure distribution, with an emphasis on lower limb alignment.
83 participants were recruited: 29 healthy subjects, 29 MM patients with neutral alignment (-3°< hip-knee-ankle angle (HKA) ≤ 3°), and 25 MM patients with varus alignment (HKA > 3°). Plantar pressure was measured using a shoe-integrated detection system. Normalized peak force, center-of-pressure (COP), and time-to-boundary (TTB) were measured during walking and single-leg stance (SLS).
During walking, compared to the healthy group, the varus alignment group showed lower peak force for the posterior heel (P = 0.012), lateral midfoot (P = 0.024) and hallux (P = 0.009). When the two sides were compared, the varus group exhibited a lower peak force in the anterior heel (P = 0.004) and hallux (P = 0.017) of the affected sides, the neutral (P = 0.043) and varus (P = 0.045) groups all showed higher medio-lateral COP of the unaffected sides, indicating the COP shifting laterally. In SLS test, the two MM groups demonstrated increased peak force of the third (P = 0.037) and fifth (P = 0.040) metatarsals compared to the healthy group, the peak force of the posterior heel were lower in the varus alignment group compared to the healthy group (P = 0.007) and the neutral alignment group (P = 0.008). And the TTB absolute value of medial-lateral direction of the two MM groups were lower than healthy controls (P = 0.029). The area under the receiver operating characteristic curve (AUC = 0.698, P = 0.016) suggested that peak force of posterior heel had good performance to discriminate varus alignment group from neutral alignment group.
MM injuries, especially with varus alignment, lead to significant changes in plantar pressure distribution and postural stability. These insights are clinically significant for designing early, biomechanically-informed rehabilitative strategies to optimize recovery and prevent further joint degeneration following MM injuries.
内侧半月板（MM）损伤很常见，且常导致膝关节骨关节炎（KOA）。虽然研究主要关注关节退变，但诸如姿势控制等外在因素的作用仍未得到充分探索。本研究调查了MM损伤如何影响姿势控制，特别是足底压力分布，并着重关注下肢对线情况。
招募了83名参与者：29名健康受试者、29名下肢对线中立（-3°＜髋-膝-踝角（HKA）≤3°）的MM患者以及25名下肢对线内翻（HKA＞3°）的MM患者。使用鞋内集成检测系统测量足底压力。在步行和单腿站立（SLS）过程中测量归一化峰值力、压力中心（COP）和边界时间（TTB）。
在步行过程中，与健康组相比，内翻对线组后足跟（P = 0.012）、足中外侧（P = 0.024）和拇趾（P = 0.009）的峰值力较低。当比较两侧时，内翻组患侧前足跟（P = 0.004）和拇趾（P = 0.017）的峰值力较低，中立（P = 0.043）和内翻（P = 0.045）组未患侧的内外侧COP均较高，表明COP向外侧偏移。在SLS测试中，与健康组相比，两个MM组第三（P = 0.037）和第五（P = 0.040）跖骨的峰值力增加，内翻对线组后足跟的峰值力低于健康组（P = 0.007）和中立对线组（P = 0.008）。并且两个MM组内外侧方向的TTB绝对值均低于健康对照组（P = 0.029）。受试者工作特征曲线下面积（AUC = 0.698，P = 0.016）表明，后足跟峰值力在区分内翻对线组和中立对线组方面具有良好性能。
MM损伤，尤其是伴有内翻对线时，会导致足底压力分布和姿势稳定性发生显著变化。这些见解对于设计早期的、基于生物力学的康复策略具有临床意义，以优化恢复并预防MM损伤后进一步的关节退变。
