The knee adduction moment and knee osteoarthritis symptoms: relationships according to radiographic disease severity

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• 作者：M. Hall^&dagger ; ; K.L. Bennell^&dagger ; ; T.V. Wrigley^&dagger ; ; B.R. Metcalf^&dagger ; ; P.K. Campbell^&dagger ; ; J. Kasza^&dagger ; ; ^&Dagger ; ; K.L. Paterson^&dagger ; ; D.J. Hunter^§ ; ; ^‖ ; R.S. Hinman^&dagger ; ; ^{ranash@unimelb.edu.au}
• 关键词：Knee joint loading ; Pain ; Physical function ; Disease severity
• 刊名：Osteoarthritis and Cartilage
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：25
• 期：1
• 页码：34-41
• 全文大小：250 K
• 卷排序：25

文摘

To investigate relationships between external knee adduction moment parameters (KAM) and osteoarthritis (OA) symptoms according to disease severity.Design164 participants with symptomatic medial knee OA were included. Radiographic severity was graded by (1) Kellgren & Lawrence (KL) scale (Grade 2, n = 49; Grade, n = 52; Grade 4, n = 63) and; (2) medial tibiofemoral joint space narrowing (JSN) (Grade 1, n = 47; Grade 2, n = 50; Grade 3, n = 67). KAM-related parameters (peak KAM, KAM impulse and cumulative load) were determined from three-dimensional gait analysis and pedometry. Cumulative load was determined by multiplying KAM impulse by the average number of steps/day recorded over at least 5 days. Symptoms were assessed via numeric rating scale ((NRS), pain) and Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index (pain and physical function). Relationships between KAM parameters (independent variables) and symptoms (dependent variables) were evaluated by radiographic severity using linear models, adjusting for covariates.ResultsIn mild disease (either KL Grade 2 or JSN Grade 1), there were no associations between KAM and symptoms. In moderate disease of KL Grade 3, higher KAM impulse was associated with greater WOMAC pain. In severe disease (KL Grade 4), higher KAM impulse was associated with less WOMAC pain (KL Grade 4), while higher peak KAM was associated with better function (KL Grade 4). Higher cumulative knee adduction load was associated with less pain on both NRS and WOMAC (JSN Grade 3) as well as better function (both JSN Grade 3 and KL Grade 4).ConclusionsRelationships between KAM-related parameters and symptoms differ according to underlying radiographic OA severity.