Goel A, Loudon J, Nazare A, Rondinelli R, Hassanein K
Department of Rehabilitation Medicine, University of Kansas Medical Center, Kansas City, USA.
Am J Orthop (Belle Mead NJ). 1997 Dec;26(12):852-6.
A biomechanical analysis was performed to determine if a minor limb length discrepancy alters lower extremity joint mechanics significantly and in a manner that could contribute to the development of joint abnormalities. Ten healthy subjects with equal limb lengths were recruited. Gait analysis was performed for both left and right sides to determine the maximum moments at the hip, knee, and ankle joints. A minor limb length discrepancy was simulated by adding a shoe lift of 1.25 cm to the left leg. After a period of acclimation, the gait was reanalyzed. Differences for maximum joint moments at the hip, knee, and ankle before and after simulation were nonsignificant. An additional 10 healthy, asymptomatic patients with actual limb length discrepancies ranging from 1 cm to 2 cm were also recruited. Gait analysis for maximum joint moments before and after correction of the limb length discrepancy was performed. Side-to-side differences in joint moments before correction were nonsignificant. After correction of the limb length discrepancy, side-to-side joint moment differences were significantly increased (P = 0.02) and may suggest acute overcompensation to the presence of the corrective shoe lift. Consequently, this study did not find an association between minor limb length discrepancies and predictable changes in lower extremity joint kinetics that might potentially lead to joint abnormalities.
进行了一项生物力学分析,以确定轻微的肢体长度差异是否会显著改变下肢关节力学,以及是否会以可能导致关节异常发展的方式改变。招募了10名肢体长度相等的健康受试者。对左右两侧进行步态分析,以确定髋关节、膝关节和踝关节的最大力矩。通过在左腿上加一个1.25厘米的鞋垫来模拟轻微的肢体长度差异。经过一段时间的适应后,重新分析步态。模拟前后髋关节、膝关节和踝关节最大关节力矩的差异不显著。另外还招募了10名实际肢体长度差异在1厘米至2厘米之间的健康无症状患者。对肢体长度差异矫正前后的最大关节力矩进行步态分析。矫正前关节力矩的左右差异不显著。矫正肢体长度差异后,左右关节力矩差异显著增加(P = 0.02),这可能表明对矫正鞋垫的存在有急性过度补偿。因此,本研究未发现轻微肢体长度差异与下肢关节动力学的可预测变化之间存在关联,而这种变化可能潜在地导致关节异常。