Purpose

To evaluate the kinematics/kinetics of the ankle, knee, hip in the sagittal plane in adolescents with recurrent patellar dislocation in comparison to a healthy control.

Methods

Case–control study. Eighty-eight knees (67 patients) with recurrent patellar dislocation (mean age 14.8 years ± 2.8 SD) were compared to 54 healthy knees (27 individuals, 14.9 years ± 2.4 SD). Kinematics/kinetics of ankle, knee, hip, and pelvis were captured using 3D-gait analysis (VICON, 12 cameras, 200 Hz, Plug-in-Gait, two force plates). One cycle (100%) consisted of 51 data-points. The mean of six trials was computed.

Results

The loading-response increased by 0.02 s ± 0.01SE (10.8%) with dislocations (0.98% of total gait, P < 0.01). The mid-stance-phase decreased equally (P < 0.01). Dislocation decreased knee flexion during the entire gait cycle (P < 0.01), with the largest difference during mid-stance (9.0° ± 7.2 SD vs. 18.5° ± 6.7 SD). Dislocation increased plantar-flexion during loading response 4.1° ± 0.4 SE with (P < 0.01), afterward, the dorsal-extension decreased 3.2° ± 0.3 SE, (P < 0.01). Dislocation decreased hip flexion during all phases (P < 0.01). Maximal difference: 7.5° ± 0.5 SE during mid-stance. 80% of all patients developed this gait pattern.

Internal moments of the ankle increased, of the knee and hip decreased during the first part of stance.

Conclusion

Recurrent patellar dislocation decreases knee flexion during the loading-response and mid-stance phase. A decreased hip flexion and increased plantar-flexion, while adjusting internal moments, indicate a compensation mechanism.

Level of evidence

III.

中文翻译：

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青少年反复发生的pa骨脱位导致整个步态周期中膝关节屈曲减少。

目的

与健康对照组比较，评估青少年pa骨脱位的矢状面踝，膝，髋的运动学/运动学。

方法

病例对照研究。比较了88例膝关节re骨脱位（平均年龄14.8岁±2.8 SD）的膝盖（67例）与54例健康膝关节（27个个体，14.9岁±2.4 SD）的健康膝盖。使用3D步态分析（VICON，12个摄像头，200 Hz，步态即插即用，两个测力板）捕获踝，膝，髋和骨盆的运动学/动力学。一个周期（100％）由51个数据点组成。计算了六次试验的平均值。

结果

脱位（总步态的0.98％，P  <0.01）使载荷反应增加0.02 s±0.01SE（10.8％）。中位期平均下降（P  <0.01）。脱位减少了整个步态周期的膝关节屈曲（P  <0.01），中间姿势时差异最大（9.0°±7.2 SD与18.5°±6.7 SD）。在负荷反应期间，脱位使足底屈曲增加4.1°±0.4 SE，（P  <0.01），之后，背侧延伸下降3.2°±0.3 SE，（P  <0.01）。脱位在所有阶段均降低了髋屈曲（P  <0.01）。最大差异：中间姿势时7.5°±0.5 SE。所有患者中有80％出现了这种步态模式。

在站立的第一部分中，踝关节的内部力矩增加，膝盖和臀部的内部力矩减小。

结论

反复的current骨脱位在负荷反应和中位站立阶段减少了膝盖的屈曲。髋关节屈曲减少和足底屈曲增加，同时调节内部力矩，表明了一种补偿机制。

证据水平

三，