超声波检测到的渗出-滑膜炎与 ACL 重建后行走时肢体负荷率不对称程度增大有关:试点研究

Harkey MS , Grozier CD , Tolzman J , Parmar A , Fagan M , Collins K , Kuenze C , Fajardo R
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引用次数: 0

摘要

目的 前交叉韧带重建(ACLR)后常见的慢性炎症和行走生物力学改变会导致骨关节炎的发生。需要临床可用的技术来监测炎症(超声评估渗出-滑膜炎)和行走生物力学(测力鞋垫),而且必须改进这些评估的转化,并确定前交叉韧带重建术后患者的炎症和行走生物力学是否相关。本研究旨在确定 ACLR 术后 1-5 年患者超声检测到的膝关节积液-滑膜炎与行走时肢体负荷不对称之间的关系。设计15 名参与者(9 名女性;年龄:26 ± 6 岁;体重:71 ± 15 千克;身高:173 ± 9 厘米;ACLR 术后月数:29 ± 13)参与了这项横断面研究。采用标准化方案对膝关节渗出-滑膜炎进行评估,并使用经过验证的评分图谱(0 = 无,1 = 轻度,2 = 中度,3 = 重度)对 ACLR 患肢进行评分。测力鞋垫用于捕捉一分钟跑步机行走试验中的垂直地面反作用力(vGRF)。肢体对称性指数(LSI)用于量化峰值vGRF和瞬时负荷率(vGRF-LR)的肢体负荷不对称情况。结果13/15(87%)名参与者的 ACLR 患肢存在渗出性滑膜炎(0 级:n = 2;1 级:n = 8;2 级:n = 4,3 级:n = 1)。积液-滑膜炎等级与 vGRF LSI 峰值无显著相关性(平均值±sd:98.0 ± 5.6;ρ = 0.38,p = 0.162),但与 vGRF-LR LSI 有显著相关性(98.2 ± 11.4;ρ = 0.55,p = 0.035)。结论大多数接受 ACLR 后 1-5 年的参与者都有超声检测出的渗出性滑膜炎,渗出性滑膜炎较严重的参与者会更快地负重。这项研究强调了临床可用技术在评估 ACLR 患者炎症和行走生物力学方面的实用性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Ultrasound-detected effusion-synovitis is associated with greater limb loading rate asymmetry during walking post-ACL reconstruction: A pilot study

Objective

Chronic inflammation and altered walking biomechanics are common after ACL reconstruction (ACLR) and contribute to the development of osteoarthritis. Clinically accessible techniques are needed to monitor inflammation (ultrasound-assessed effusion-synovitis) and walking biomechanics (force-measuring insoles), and they must improve the translation of these assessments and determine whether inflammation and walking biomechanics are related in patients after ACLR. This study aimed to determine the association between ultrasound-detected knee effusion-synovitis and limb loading asymmetries during walking in patients 1–5 years post-ACLR.

Design

15 participants (9 women; age: 26 ± 6yrs; mass: 71 ± 15 kg; height: 173 ± 9 cm; months post-ACLR: 29 ± 13) were included in this cross-sectional study. Knee effusion-synovitis was assessed using a standardized protocol and graded using a validated scoring atlas (0 = absent, 1 = mild, 2 = moderate, 3 = severe) in the ACLR limb. Force-measuring insoles were used to capture the vertical ground reaction force (vGRF) during a one-minute treadmill walking trial. Limb symmetry indices (LSIs) were used to quantify limb loading asymmetry for the peak vGRF and the instantaneous loading rate (vGRF-LR). Spearman correlations determined whether effusion-synovitis grade was associated with peak vGRF and vGRF-LR LSI.

Results

Effusion-synovitis was present in the ACLR limb of 13/15 (87 %) participants (Grade 0: n = 2; Grade 1: n = 8; Grade2: n = 4, Grade3: n = 1). Effusion-synovitis grade was not significantly associated with peak vGRF LSI (mean±sd: 98.0 ± 5.6; ρ = 0.38, p = 0.162), but was significantly associated with vGRF-LR LSI (98.2 ± 11.4; ρ = 0.55, p = 0.035).

Conclusion

Most participants 1–5 years post-ACLR have ultrasound-detected effusion-synovitis. Participants with more severe effusion-synovitis load their ACLR limb more rapidly. This study highlights the utility of clinically accessible techniques in assessing inflammation and walking biomechanics in ACLR patients.

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Osteoarthritis imaging
Osteoarthritis imaging Radiology and Imaging
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