内侧间室膝骨性关节的下肢关节生物力学变化

Biomechanical Changes at Joints of Low Limb in Patients with Medial Compartment Knee Osteoarthritis

目的:了解内侧间室膝骨性关节炎患者与正常人群在行走过程中的下肢生物力学参数的差异,以便准确客观的对患者下肢功能进行评定。方法:通过三维步态分析系统和测力板分别对正常人群(正常组)25例和内侧间室膝骨性关节炎患者(患病组)25例进行时间空间以及髋、膝、踝关节的运动学和动力学参数采集,并进行比较。结果:与正常组比较,患病组在行走过程中的最大膝关节曲,踝关节跖/背屈,髋关节曲/伸角度以及关节活动范围均明显降低,髋关节内收力矩明显减小,膝关节内收力矩明显增加(均P<0.05)。结论:内侧间室膝骨性关节炎患者下肢关节生物力学发生变化,步行过程中的膝关节所受的压力明显高于正常人群,为其康复评定及治疗提供客观评价依据。

Objective：To understand the difference in biomechanical changes at joints of low limb between medial knee osteoarthritis（OA） patients and normal subjects.Methods：Kinematic and spatial-temporal changes were compared by using 3-dimensional gait analysis system and the kinetic changes were collected by the force platforms in two groups：normal control group,medial knee OA group.Results：Compared to the control group,the medial knee OA group showed significant smaller hip adduction moments,and higher knee adduction moments（P0.05） during walking.Kinematic differences in medial knee OA group included decreased knee flexion angles,hip flexion/extension angles,ankle dosri/plantar-flexion angles,and range of motion at knee,hip and ankle joint in sagittal plane（P0.05）.Conclusion：Medial knee OA patients had obviously smaller joint motion in knee,hip and ankle joint during walking and higher load in the knee joint at the same time.