Both structural and clinical changes can signify knee osteoarthritis progression; however, these changes are not always concurrent. A better understanding of mechanical factors associated with progression and whether they differ for structural versus clinical outcomes could lead to improved conservative management. This study examined baseline gait differences between progression and no progression groups defined at an average of 7-year follow-up using 2 different outcomes indicative of knee osteoarthritis progression: radiographic medial joint space narrowing and total knee arthroplasty. Of 49 individuals with knee osteoarthritis who underwent baseline gait analysis, 32 progressed and 17 did not progress using the radiographic outcome, while 13 progressed and 36 did not progress using the arthroplasty outcome. Key knee moment and electromyography waveform features were extracted using principal component analysis, and confidence intervals were used to examine between-group differences in these metrics. Those who progressed using the arthroplasty outcome had prolonged rectus femoris and lateral hamstrings muscle activation compared with the no arthroplasty group. Those with radiographic progression had greater mid-stance internal knee rotation moments compared with the no radiographic progression group. These results provide preliminary evidence for the role of prolonged muscle activation in total knee arthroplasty, while radiographic changes may be related to loading magnitude.

中文翻译：

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使用临床结果和结构结果定义时与膝骨关节炎进展相关的基线关节力矩和肌肉激活模式的差异。

结构和临床变化都可能预示着膝骨关节炎的进展。然而，这些变化并不总是同时发生的。更好地了解与进展相关的机械因素以及它们在结构性结果与临床结果上是否存在差异可能会导致保守治疗的改善。这项研究检查了平均 7 年随访时定义的进展组和无进展组之间的基线步态差异，使用两种指示膝骨关节炎进展的不同结果：放射学内侧关节间隙狭窄和全膝关节置换术。在接受基线步态分析的 49 名膝骨关节炎患者中，根据放射学结果，32 人进展，17 人未进展，而根据关节成形术结果，13 人进展，36 人未进展。使用主成分分析提取关键的膝力矩和肌电图波形特征，并使用置信区间来检查这些指标的组间差异。与未进行关节置换术的组相比，那些使用关节置换术取得进展的患者股直肌和外侧腘绳肌的激活时间延长。与无放射学进展组相比，放射学进展组的中站立位内膝旋转力矩更大。这些结果为全膝关节置换术中延长肌肉激活的作用提供了初步证据，而放射学变化可能与负荷大小有关。