Yongjie Li, Runxin Luo, Shuwen Luo, Mengling Liu, Hongju Liu
{"title":"单侧膝关节骨性关节炎患者膝关节内收力矩不对称的影响因素分析。","authors":"Yongjie Li, Runxin Luo, Shuwen Luo, Mengling Liu, Hongju Liu","doi":"10.1186/s12891-024-07956-3","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The knee adduction moment(KAM) of both lower limbs in patients with unilateral knee osteoarthritis(KOA) exhibits asymmetry during walking, but the factors influencing this asymmetry remain unclear. This study aimed to explore the influencing factors of KAM asymmetry in patients with unilateral KOA.</p><p><strong>Methods: </strong>A total of 148 patients with unilateral medial compartment KOA were selected for this retrospective study, and general data such as gender, age, and duration of disease were collected. The hip-knee-ankle (HKA) angle, degree of pain, and knee-extension muscle strength on the affected side were assessed through radiographic outcomes, the visual analog scale(VAS), and the Biodex isokinetic system. The peak KAM of both lower limbs was analyzed using a BTS motion-capture system and force platform. The asymmetry index(ASI) of KAM was calculated, and the patients were further categorized into the KAM symmetry group(ASI value ≤ 10%) and the KAM asymmetry group(ASI value>10%).Binary logistic regression analysis was employed to analyze the factors influencing the asymmetry of KAM.</p><p><strong>Results: </strong>90 patients were categorized into the KAM asymmetry group, representing 60.8% of the cohort. A significant difference in the ASI value of KAM was observed between the two groups. Correlation analysis identified nine factors, including sex, age, and BMI, that were positively correlated with the ASI value of KAM. In contrast, knee-extension muscle strength and per-capita monthly household income were negatively correlated with the ASI value of KAM. Regression analysis revealed that being female(OR = 1.752), older age(OR = 2.472), increased BMI(OR = 1.535), larger varus angle(OR = 3.965), higher VAS score(OR = 2.617), Kellgren-Lawrence(K-L) grade IV(OR = 4.474), history of knee joint trauma(OR = 5.684), and living in a rural location(OR = 1.554) increased the risk of KAM asymmetry. Conversely, increased knee-extension muscle strength(OR = 0.758) and a per-capita monthly household income of 3000 ~ 6000 yuan(OR = 0.814) decreased the risk of KAM asymmetry.</p><p><strong>Conclusion: </strong>Female gender, older age, increased BMI, larger varus angle, higher VAS score, K-L grade IV, history of knee joint trauma, and living in a rural location are identified as risk factors for KAM asymmetry. Conversely, increased knee-extension muscle strength and a per-capita monthly household income of 3000 ~ 6000 yuan serve as protective factors against this asymmetry.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":null,"pages":null},"PeriodicalIF":2.2000,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11495046/pdf/","citationCount":"0","resultStr":"{\"title\":\"Influencing factors analysis of asymmetry in knee adduction moment among patients with unilateral knee osteoarthritis.\",\"authors\":\"Yongjie Li, Runxin Luo, Shuwen Luo, Mengling Liu, Hongju Liu\",\"doi\":\"10.1186/s12891-024-07956-3\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The knee adduction moment(KAM) of both lower limbs in patients with unilateral knee osteoarthritis(KOA) exhibits asymmetry during walking, but the factors influencing this asymmetry remain unclear. This study aimed to explore the influencing factors of KAM asymmetry in patients with unilateral KOA.</p><p><strong>Methods: </strong>A total of 148 patients with unilateral medial compartment KOA were selected for this retrospective study, and general data such as gender, age, and duration of disease were collected. The hip-knee-ankle (HKA) angle, degree of pain, and knee-extension muscle strength on the affected side were assessed through radiographic outcomes, the visual analog scale(VAS), and the Biodex isokinetic system. The peak KAM of both lower limbs was analyzed using a BTS motion-capture system and force platform. The asymmetry index(ASI) of KAM was calculated, and the patients were further categorized into the KAM symmetry group(ASI value ≤ 10%) and the KAM asymmetry group(ASI value>10%).Binary logistic regression analysis was employed to analyze the factors influencing the asymmetry of KAM.</p><p><strong>Results: </strong>90 patients were categorized into the KAM asymmetry group, representing 60.8% of the cohort. A significant difference in the ASI value of KAM was observed between the two groups. Correlation analysis identified nine factors, including sex, age, and BMI, that were positively correlated with the ASI value of KAM. In contrast, knee-extension muscle strength and per-capita monthly household income were negatively correlated with the ASI value of KAM. Regression analysis revealed that being female(OR = 1.752), older age(OR = 2.472), increased BMI(OR = 1.535), larger varus angle(OR = 3.965), higher VAS score(OR = 2.617), Kellgren-Lawrence(K-L) grade IV(OR = 4.474), history of knee joint trauma(OR = 5.684), and living in a rural location(OR = 1.554) increased the risk of KAM asymmetry. Conversely, increased knee-extension muscle strength(OR = 0.758) and a per-capita monthly household income of 3000 ~ 6000 yuan(OR = 0.814) decreased the risk of KAM asymmetry.</p><p><strong>Conclusion: </strong>Female gender, older age, increased BMI, larger varus angle, higher VAS score, K-L grade IV, history of knee joint trauma, and living in a rural location are identified as risk factors for KAM asymmetry. 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引用次数: 0
摘要
背景:单侧膝关节骨性关节炎(KOA)患者行走时双下肢的膝内收力矩(KAM)不对称,但这种不对称的影响因素仍不清楚。本研究旨在探讨单侧膝关节骨性关节炎患者 KAM 不对称的影响因素:这项回顾性研究共选取了 148 名单侧内侧室 KOA 患者,收集了他们的性别、年龄和病程等一般数据。通过影像学结果、视觉类比量表(VAS)和 Biodex 等动系统评估患侧的髋膝踝(HKA)角度、疼痛程度和膝关节伸展肌力。使用 BTS 运动捕捉系统和力平台分析了双下肢的 KAM 峰值。计算KAM的不对称指数(ASI),并将患者进一步分为KAM对称组(ASI值≤10%)和KAM不对称组(ASI值>10%):90名患者被归入KAM不对称组,占队列的60.8%。两组患者的 KAM ASI 值存在明显差异。相关性分析发现,包括性别、年龄和体重指数在内的九个因素与 KAM 的 ASI 值呈正相关。相比之下,膝关节伸展肌力和家庭人均月收入与甘油三酯 ASI 值呈负相关。回归分析表明,女性(OR = 1.752)、年龄较大(OR = 2.472)、体重指数增加(OR = 1.535)、膝关节外翻角度较大(OR = 3.965)、VAS评分较高(OR = 2.617)、Kellgren-Lawrence(K-L)IV级(OR = 4.474)、膝关节外伤史(OR = 5.684)和居住在农村地区(OR = 1.554)会增加KAM不对称的风险。相反,膝关节伸展肌力增加(OR = 0.758)和家庭人均月收入在 3000-6000 元之间(OR = 0.814)会降低膝关节不对称的风险:结论:女性、高龄、体重指数增加、外翻角度增大、VAS评分较高、K-L分级IV级、膝关节外伤史和居住在农村地区是KAM不对称的危险因素。相反,膝关节伸展肌力增强和家庭人均月收入在 3000-6000 元之间则是防止膝关节不对称的保护因素。
Influencing factors analysis of asymmetry in knee adduction moment among patients with unilateral knee osteoarthritis.
Background: The knee adduction moment(KAM) of both lower limbs in patients with unilateral knee osteoarthritis(KOA) exhibits asymmetry during walking, but the factors influencing this asymmetry remain unclear. This study aimed to explore the influencing factors of KAM asymmetry in patients with unilateral KOA.
Methods: A total of 148 patients with unilateral medial compartment KOA were selected for this retrospective study, and general data such as gender, age, and duration of disease were collected. The hip-knee-ankle (HKA) angle, degree of pain, and knee-extension muscle strength on the affected side were assessed through radiographic outcomes, the visual analog scale(VAS), and the Biodex isokinetic system. The peak KAM of both lower limbs was analyzed using a BTS motion-capture system and force platform. The asymmetry index(ASI) of KAM was calculated, and the patients were further categorized into the KAM symmetry group(ASI value ≤ 10%) and the KAM asymmetry group(ASI value>10%).Binary logistic regression analysis was employed to analyze the factors influencing the asymmetry of KAM.
Results: 90 patients were categorized into the KAM asymmetry group, representing 60.8% of the cohort. A significant difference in the ASI value of KAM was observed between the two groups. Correlation analysis identified nine factors, including sex, age, and BMI, that were positively correlated with the ASI value of KAM. In contrast, knee-extension muscle strength and per-capita monthly household income were negatively correlated with the ASI value of KAM. Regression analysis revealed that being female(OR = 1.752), older age(OR = 2.472), increased BMI(OR = 1.535), larger varus angle(OR = 3.965), higher VAS score(OR = 2.617), Kellgren-Lawrence(K-L) grade IV(OR = 4.474), history of knee joint trauma(OR = 5.684), and living in a rural location(OR = 1.554) increased the risk of KAM asymmetry. Conversely, increased knee-extension muscle strength(OR = 0.758) and a per-capita monthly household income of 3000 ~ 6000 yuan(OR = 0.814) decreased the risk of KAM asymmetry.
Conclusion: Female gender, older age, increased BMI, larger varus angle, higher VAS score, K-L grade IV, history of knee joint trauma, and living in a rural location are identified as risk factors for KAM asymmetry. Conversely, increased knee-extension muscle strength and a per-capita monthly household income of 3000 ~ 6000 yuan serve as protective factors against this asymmetry.
期刊介绍:
BMC Musculoskeletal Disorders is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of musculoskeletal disorders, as well as related molecular genetics, pathophysiology, and epidemiology.
The scope of the Journal covers research into rheumatic diseases where the primary focus relates specifically to a component(s) of the musculoskeletal system.