膝关节对齐在疾病进展和功能衰退中的作用 膝关节骨关节炎
1Northwestern University Medical School, 303 E Chicago Ave, Ward Bldg 3-315, Chicago, IL 60611, USA. L-Sharma@northwestern.edu
JAMA
|July 13, 2001
概括
膝盖对齐显著影响骨关节炎 (OA) 的进展. 瓦鲁斯对齐会增加中膝关节骨质炎风险,而关节对齐会增加侧膝关节骨质炎风险,不对齐会预测功能衰退.
科学领域:
- 整形外科 整形外科 整形外科
- 类风湿病学 类风湿病学
- 生物机械工程 生物机械工程
背景情况:
- 膝关节关节炎 (OA) 是老年人残疾的主要原因.
- 对于OA进展和功能衰退的有限风险因素是已知的.
- 部 - 膝盖 - 脚对齐影响膝盖负荷分布,部和部对齐分别增加中间和侧面的膝盖负荷.
研究的目的:
- 为了检查静脉位对齐是否会在18个月内增加中枢膝关节OA的进展.
- 为了确定关节对齐是否会增加膝关节侧面OA的进展.
- 评估错位的严重程度是否与关节空间损失和功能衰退相关.
主要方法:
- 展望纵向队列研究 (1997-2000年) 对237名具有初级膝关节OA的社区招募个体进行了研究.
- 对膝盖对齐,关节空间缩小和关节空间宽度的放射评估.
- 在基线和18个月的身体功能评估.
主要成果:
- 瓦鲁斯对齐与中枢膝关节OA进展的几率增加了4倍 (调整后OR,4.09).
- 关节对齐与侧膝关节OA进展的几率增加了近5倍 (经调整的OR,4.89).
- 在18个月内,更严重的错位严重程度与增加的关节空间损失和显著的功能恶化相关.
结论:
- 这项研究提供了第一个证据,即关节和关节膝关节对齐独立地增加了膝关节中部和侧部骨关节炎进展的风险.
- 不对齐的负担预测了随后的身体功能下降.
- 这些效应可以在观察后18个月内检测到.
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