科研之友
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摘要
Background: Anterior cruciate ligament (ACL) injury predisposes individuals to early-onset knee joint osteoarthritis (OA). Abnormal joint loading is apparent after ACL injury and reconstruction. The relationship between altered joint biomechanics and the development of knee OA is unknown. Hypothesis: Altered knee joint kinetics and medial compartment contact forces initially after injury and reconstruction are associated with radiographic knee OA 5 years after reconstruction. Study Design: Case-control study; Level of evidence, 3. Methods: Individuals with acute, unilateral ACL injury completed gait analysis before (baseline) and after (posttraining) preoperative rehabilitation and at 6 months, 1 year, and 2 years after reconstruction. Surface electromyographic and knee biomechanical data served as inputs to an electromyographically driven musculoskeletal model to estimate knee joint contact forces. Patients completed radiographic testing 5 years after reconstruction. Differences in knee joint kinetics and contact forces were compared between patients with and those without radiographic knee OA. Results: Patients with OA walked with greater frontal plane interlimb differences than those without OA (nonOA) at baseline (peak knee adduction moment difference: 0.00 0.08 Nm/kgm [nonOA] vs -0.15 +/- 0.09 Nm/kgm [OA], P = .014; peak knee adduction moment impulse difference: -0.001 +/- 0.032 Nms/kgm [nonOA] vs -0.048 +/- 0.031 Nms/kgm [OA], P = .042). The involved limb knee adduction moment impulse of the group with osteoarthritis was also lower than that of the group without osteoarthritis at baseline (0.087 +/- 0.023 Nms/kgm [nonOA] vs 0.049 +/- 0.018 Nms/kgm [OA], P = .023). Significant group differences were absent at posttraining but reemerged 6 months after reconstruction (peak knee adduction moment difference: 0.02 +/- 0.04 Nm/kgm [nonOA] vs -0.06 +/- 0.11 Nm/kgm [OA], P = .043). In addition, the OA group walked with lower peak medial compartment contact forces of the involved limb than did the group without OA at 6 months (2.89 +/- 0.52 body weight [nonOA] vs 2.10 +/- 0.69 body weight [OA], P = .036). Conclusion: Patients who had radiographic knee OA 5 years after ACL reconstruction walked with lower knee adduction moments and medial compartment joint contact forces than did those patients without OA early after injury and reconstruction.
- 出版日期2016-1
