Influences of alignment and obesity on knee joint loading in osteoarthritic gait

被引:64
作者
Messier, S. P. [1 ,2 ]
Pater, M. [1 ]
Beavers, D. P. [3 ]
Legault, C. [3 ]
Loeser, R. F. [4 ]
Hunter, D. J. [5 ]
DeVita, P. [6 ]
机构
[1] Wake Forest Univ, Dept Hlth & Exercise Sci, Winston Salem, NC 27109 USA
[2] Wake Forest Univ, Sect Gerontol & Geriatr Med, Winston Salem, NC 27109 USA
[3] Wake Forest Sch Med, Dept Publ Hlth Sci, Winston Salem, NC USA
[4] Univ N Carolina, Div Rheumatol Allergy & Immunol, Thurston Arthrit Res Ctr, Chapel Hill, NC USA
[5] Univ Sydney, Dept Rheumatol, Northern Clin Sch, Sydney, NSW 2006, Australia
[6] E Carolina Univ, Dept Kinesiol, Greenville, NC USA
基金
美国国家卫生研究院;
关键词
Body mass index; Varus; Knee joint force; IN-VIVO; DISEASE PROGRESSION; ADDUCTION MOMENT; INTENSIVE DIET; RISK-FACTOR; WALKING; TRIAL; EXERCISE; PREDICT; FORCES;
D O I
10.1016/j.joca.2014.05.013
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
100224 [整形外科学];
摘要
Objective: To determine the influences of frontal plane knee alignment and obesity on knee joint loads in older, overweight and obese adults with knee osteoarthritis (OA). Methods: Cross-sectional investigation of alignment and obesity on knee joint loads using community dwelling older adults (age >= 55 years; 27 kg m(-2) >= body mass or body mass index (BMI) <= 41 kg m(-2); 69% female) with radiographic knee OA that were a subset of participants (157 out of 454) enrolled in the Intensive Diet and Exercise for Arthritis (IDEA) clinical trial. Results: A higher BMI was associated with greater (P = 0.0006) peak knee compressive forces [overweight, 2411 N (2182, 2639), class 1 obesity, 2772 N (2602, 2943), class 2+ obesity, 2993 N (2796, 3190)] and greater (P = 0.004) shear forces [overweight, 369 N (322, 415), class 1 obesity, 418 N (384, 453), class 2+ obesity, 472 N (432, 513)], independent of alignment, and varus alignment was associated (P < 0.0001) with greater peak external knee adduction moments, independent of BMI [valgus, 18.7 Nm (15.1, 22.4), neutral, 27.7 Nm (24.0, 31.4), varus, 37.0 Nm (34.4, 39.7)]. Conclusion: BMI and alignment were associated with different joint loading measures; alignment was more closely associated with the asymmetry or imbalance of loads across the medial and lateral knee compartments as reflected by the frontal plane external adduction moment, while BMI was associated with the magnitude of total tibiofemoral force. These data may be useful in selecting treatment options for knee OA patients (e.g., diet to reduce compressive loads or bracing to change alignment). (C) 2014 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.
引用
收藏
页码:912 / 917
页数:6
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