膝内翻距下关节补偿能力异常的病理生理学。

IF 1.5 4区 医学 Q3 ORTHOPEDICS Journal of Orthopaedic Science Pub Date : 2024-09-01 DOI:10.1016/j.jos.2023.09.009
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引用次数: 0

摘要

背景:近年来,有报道称距下关节的补偿能力参与下肢对齐。我们之前已经表明,后脚对齐角(HAA)是距下关节补偿能力的指标。距下关节的异常补偿能力是由距下关节活动度定义的,对距下关节运动度的评估可能有助于进一步阐明距下关节异常补偿能力的病理生理学。本研究旨在评估距下关节的活动性,并阐明膝内翻中距下关节异常补偿能力的病理生理学。方法:72例年龄≥40岁膝内翻患者的72个膝关节纳入本研究。术前X线片用于测量本研究的参数。基于我们之前的研究,我们将HAA≥15.9°定义为距下关节的异常补偿能力。将患者分为异常组(A组)和正常组(N组)。比较各组之间的所有测量参数,并分析HAA与每个测量参数之间的相关性。结果:负重后足角(WBHA)(p结论:膝内翻距下关节补偿能力异常的病理生理学被认为涉及后足外翻增加和无法进入正常后足对齐的状态。证据水平:Ⅲ级,回顾性研究。
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Pathophysiology of abnormal compensation ability of the subtalar joint in the varus knee

Background

In recent years, the involvement of the compensation ability of the subtalar joint in lower extremity alignment has been reported. We previously showed that hindfoot alignment angle (HAA) is an indicator of compensation ability of the subtalar joint. The abnormal compensation ability of the subtalar joint was defined by the mobility of the subtalar joint, and evaluation of the mobility of the subtalar joint may help to further clarify the pathophysiology of abnormal compensation ability of the subtalar joint. This study was performed to evaluate the mobility of the subtalar joint and clarify the pathophysiology of abnormal compensation ability of the subtalar joint in the varus knee.

Methods

Seventy-two knees of 72 patients aged ≥40 years with varus knee were included in this study. Preoperative radiographs were used for measurement of this study parameters. Based on our previous study, we defined HAA of ≥15.9°as abnormal compensation ability of the subtalar joint. The patients were divided into an abnormal group (A-group) and normal group (N-group). All measurement parameters were compared between the groups, and correlations between the HAA and each measurement parameter were analyzed.

Results

The weight-bearing hindfoot angle (WBHA) (p < 0.001) and non-weight-bearing hindfoot angle (non-WBHA) (p = 0.003), were significantly greater in the A-group than in the N-group. Conversely, the ratio of change in hindfoot alignment (p = 0.006), were significantly smaller in the A-group than in the N-group. The HAA was positively correlated with WBHA (r = 0.66) and non-WBHA (r = 0.43) and negatively correlated with the ratio of change in hindfoot alignment (r = −0.32).

Conclusions

The pathophysiology of abnormal compensation ability of the subtalar joint in the varus knee is thought to involve a state of increased valgus of hindfoot alignment and an inability to move into normal hindfoot alignment.

Level of evidence

Level Ⅲ, retrospective study.

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来源期刊
Journal of Orthopaedic Science
Journal of Orthopaedic Science 医学-整形外科
CiteScore
3.00
自引率
0.00%
发文量
290
审稿时长
90 days
期刊介绍: The Journal of Orthopaedic Science is the official peer-reviewed journal of the Japanese Orthopaedic Association. The journal publishes the latest researches and topical debates in all fields of clinical and experimental orthopaedics, including musculoskeletal medicine, sports medicine, locomotive syndrome, trauma, paediatrics, oncology and biomaterials, as well as basic researches.
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