Femoral Translation in Patients with Unicompartmental Osteoarthritis—A Cohort Study

Mathis Wegner, Simon Kuwert, Stefan Kratzenstein, Maciej J. K. Simon, Babak Moradi
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Abstract

The use of three-dimensional (3D) gait analysis to image femorotibial translation can aid in the diagnosis of pathology and provide additional insight into the severity of KOA (knee osteoarthritis). Femorotibial translation is of particular importance in patients undergoing UKA (unicompartmental knee arthroplasty), as the absence or elongation of ligamentous structures results in changes in the kinematic alignment. The aim of the study was to evaluate the parameters of femorotibial translation in patients with MOA (medial unicompartmental OA). An artificial model was employed to develop a method for calculating femorotibial translation in vitro. In a prospective cohort study, gait data using three-dimensional gait analysis were collected from 11 patients (68.73 ± 9.22 years) with severe OA scheduled for UKA and 29 unmatched healthy participants (22.07 ± 2.23 years). The discrete variables characterising femorotibial translation were compared for statistical significance (p < 0.05) using the Student’s t-test and the Mann–Whitney U-test. The results of the study validated an artificial model to mimic femorotibial translation. The comparison of patients scheduled for UKA and a healthy unmatched control group showed no statistically significant differences concerning femorotibial translation in all three planes (p > 0.05). However, the PROMs (patient-reported outcome measures), spatiotemporal, and kinematic parameters showed statistically significant differences between the groups (p < 0.001). The data presented here demonstrate typical changes in PROMs as well as spatiotemporal and kinematic outcomes for MOA as seen in knee OA. The results of the clinical gait analyses demonstrate individualised femorotibial translation. The extent of individual femorotibial translation may prove to be an important parameter for altered joint kinematics in patients with MOA, especially prior to UKA implantation.
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单关节骨关节炎患者的股骨转位--队列研究
利用三维(3D)步态分析对股骨胫骨平移进行成像,有助于病理诊断,并能进一步了解膝关节骨性关节炎(KOA)的严重程度。股胫骨平移对于接受 UKA(单髁膝关节置换术)的患者尤为重要,因为韧带结构的缺失或拉长会导致运动学排列的改变。本研究旨在评估MOA(内侧单关节OA)患者的股胫骨平移参数。研究人员利用人工模型开发了一种体外计算股胫骨平移的方法。在一项前瞻性队列研究中,利用三维步态分析收集了11名计划接受UKA治疗的重度OA患者(68.73 ± 9.22岁)和29名不匹配的健康参与者(22.07 ± 2.23岁)的步态数据。使用学生 t 检验和 Mann-Whitney U 检验比较了股胫骨平移离散变量的统计学意义(P < 0.05)。研究结果验证了模拟股胫骨平移的人工模型。对计划进行UKA的患者和未匹配的健康对照组进行比较后发现,在所有三个平面上,股胫骨平移的差异均无统计学意义(P > 0.05)。然而,PROMs(患者报告的结果测量)、时空和运动学参数显示,两组之间存在显著的统计学差异(P < 0.001)。本文提供的数据显示了膝关节 OA MOA 在 PROMs 以及时空和运动学结果方面的典型变化。临床步态分析结果表明股胫骨平移是个性化的。个体股胫骨平移的程度可能被证明是MOA患者关节运动学改变的一个重要参数,尤其是在UKA植入之前。
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