Relationship between radiographic measurements and knee adduction moment using 3D gait analysis,Gait & Posture

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Relationship between radiographic measurements and knee adduction moment using 3D gait analysis
Gait & Posture ( IF 2.2 ) Pub Date : 2021-09-01 , DOI: 10.1016/j.gaitpost.2021.08.025
Na-Kyoung Lee ₁ , Kyoung Min Lee ₁ , Heesoo Han ₁ , Seungbum Koo ₂ , Seung-Baik Kang ₃ , Chong Bum Chang ₄

Affiliation

Background

Radiographic factors estimate the state of the static knee joint, and it is questionable how well these parameters reflect the dynamic knee condition. The external knee adduction moment (KAM) during gait is known to be a kinetic variable contributing to osteoarthritis progression. This study aims to investigate the effects of static radiographic parameters on the dynamic KAM during gait.

Methods

Overall, 123 patients (mean age, 65.7 years; standard deviation, 8.1 years; 34 men and 89 women) were included. Seven radiographic parameters including the mechanical tibiofemoral angle (mTFA), Kellgren-Lawrence grade, and ankle joint line orientation (AJLO) were measured on radiographs, and the maximum KAM and KAM-time integral in the stance phase were obtained using three-dimensional gait analysis. The correlation and multiple regression analyses were performed for identifying significant radiographic measurements associated with the KAM.

Results

Most of the radiographic measurements correlated with the maximum KAM and KAM-time integral. As a result of multiple regression analysis, the mTFA (p < 0.001) and AJLO (p = 0.003) were identified as significant factors associated with the KAM-time integral (R² = 0.450); the mTFA (p < 0.001) and AJLO (p = 0.003) were identified as a significant factor associated with the maximum KAM (R² = 0.352) in multiple regression analysis. The discriminant validity of KAM was highest at varus 5.7 degree of the mTFA and 7.5 degree of the AJLO.

Significance

The mTFA and AJLO were significantly associated with the KAM. However, to be used as a surgical indication for corrective osteotomy, a longitudinal study is needed to validate whether the mTFA and AJLO values directly cause osteoarthritis progression as we have suggested.

Level of evidence

III.

中文翻译：

使用 3D 步态分析的射线照相测量值与膝关节内收力矩之间的关系

背景

放射学因素估计静态膝关节的状态，这些参数反映动态膝关节状况的程度是有问题的。已知步态期间的膝外展力矩 (KAM) 是导致骨关节炎进展的动力学变量。本研究旨在研究静态射线照相参数对步态过程中动态 KAM 的影响。

方法

总共包括 123 名患者（平均年龄 65.7 岁；标准差 8.1 岁；34 名男性和 89 名女性）。在 X 光片上测量了包括机械胫股骨角 (mTFA)、Kellgren-Lawrence 等级和踝关节线方向 (AJLO) 在内的七个射线照相参数，并使用三维步态获得了站立相中的最大 KAM 和 KAM-时间积分分析。进行相关性和多元回归分析以识别与 KAM 相关的显着放射照相测量值。

结果

大多数射线照相测量与最大 KAM 和 KAM 时间积分相关。作为多元回归分析的结果，mTFA (p < 0.001) 和 AJLO (p = 0.003) 被确定为与 KAM 时间积分相关的重要因素 (R ² = 0.450)；在多元回归分析中，mTFA (p < 0.001) 和 AJLO (p = 0.003) 被确定为与最大 KAM (R ² = 0.352)相关的重要因素。KAM 的区分效度在 mTFA 的内翻 5.7 度和 AJLO 的 7.5 度时最高。