Campbell James, Schmitt Daniel, Sands Laura P, Queen Robin M
Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, North Carolina, USA.
Department of Evolutionary Anthropology, Duke University, Durham, North Carolina, USA.
J Orthop Res. 2025 Jul;43(7):1269-1274. doi: 10.1002/jor.26087. Epub 2025 Apr 13.
Pain and disability associated with arthritis of the hip, knee, or ankle is well-documented. However, data on joint power and how arthritis in one joint affects power in that joint and in unaffected joints are limited. This study asks if arthritis in any one joint leads to (1) loss of power in that affected joint compared to the contralateral, unaffected joint; (2) loss of total power in the affected limb as compared to the contralateral, unaffected limb; and (3) increased power production in the joints of the ipsilateral limb. Ground reaction forces and joint angles during self-selected speed walking were collected from participants with symptomatic, unilateral ankle (N = 183), hip (N = 63), and knee arthritis (N = 20). Bilateral joint power from the hip, knee, and ankle joints as well as total limb power was calculated for the last third of the stance phase. Arthritis in the hip (p < 0.001), knee (p = 0.008), or ankle (p < 0.001) lead to a loss of power at the affected joint and in the affected limb, though the knee on the affected side does offset some of that loss in participants with hip and ankle arthritis (p < 0.001). The contralateral, unaffected limb (p < 0.001), especially the ankle, produces greater power. Clinical Significance: Isolated lower limb joint arthritis leads to a loss of power on the affected side and compensation by contralateral, unaffected joints. Those joints may be subsequently impacted through repetitive loading and could lead to further degeneration without intervention.
髋关节、膝关节或踝关节关节炎所伴有的疼痛和功能障碍已有充分记录。然而,关于关节力量以及一个关节的关节炎如何影响该关节及未受影响关节的力量的数据有限。本研究探讨任一关节的关节炎是否会导致:(1)与对侧未受影响的关节相比,患侧关节力量丧失;(2)与对侧未受影响的肢体相比,患侧肢体总力量丧失;以及(3)同侧肢体关节力量产生增加。在自选速度行走过程中,收集了有症状的单侧踝关节关节炎患者(N = 183)、髋关节关节炎患者(N = 63)和膝关节关节炎患者(N = 20)的地面反作用力和关节角度。计算了站立相最后三分之一时间内双侧髋关节、膝关节和踝关节的关节力量以及肢体总力量。髋关节(p < 0.001)、膝关节(p = 0.008)或踝关节(p < 0.001)的关节炎会导致患侧关节和患侧肢体力量丧失,不过患侧膝关节确实抵消了一些髋关节和踝关节关节炎患者的力量损失(p < 0.001)。对侧未受影响的肢体(p < 0.001),尤其是踝关节,产生的力量更大。临床意义:孤立的下肢关节关节炎会导致患侧力量丧失,并由对侧未受影响的关节进行代偿。这些关节随后可能因反复负荷而受到影响,如不进行干预可能会导致进一步退变。