Association of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) with Muscle Strength in Community-Dwelling Elderly with Knee Osteoarthritis.
西安大略和麦克马斯特大学骨关节炎指数 (WOMAC) 与社区老年人膝关节骨关节炎肌力的相关性。
- 作者列表："Kim MJ","Kang BH","Park SH","Kim B","Lee GY","Seo YM","Park KS","Yoo JI
PURPOSE:The purpose of this study was to evaluate the correlation between muscle strength and knee symptoms (pain, stiffness, and functional limitation) regardless of the presence of radiologic knee osteoarthritis (RKOA) in community-dwelling elderly. PATIENTS AND METHODS:This cross-sectional study used data from the Namgaram-2 cohort. The Namgaram-2 cohort consisted of participants living in three rural communities. Such participants were included for studies on activity limitation due to age-related musculoskeletal disorders including knee osteoarthritis, osteoporosis, and sarcopenia. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), a health assessment tool for patients with arthritis in lower extremities, was used to assess health-related quality of life (HRQOL). Muscle strengths were measured by knee strength (by using the isokinetic dynamometer) and hand grip strength. RESULTS:The WOMAC pain of Kallgren-Lawrence (K/L) grade < 2 was correlated with age, grip strength, nutrition status, and knee extension 180 peak torque. The WOMAC pain of K/L grade ≥ 2 was correlated with age, nutrition status, and knee extension 60 peak torque. The WOMAC stiffness of K/L grade < 2 was correlated with having a spouse, nutrition status, and knee extension 60 peak torque. The WOMAC stiffness of K/L grade ≥ 2 was correlated with knee extension 60 peak torque. The WOMAC function of K/L grade < 2 was correlated with age, grip strength, osteoporosis, nutrition status, and knee extension 180 peak torque. The WOMAC function of K/L grade ≥ 2 was correlated with age, nutrition status, and knee extension 60 peak torque. CONCLUSION:Muscle strength as measured by grip strength and knee extension was statistically significantly correlated with the WOMAC scores in patients with knee symptoms regardless of whether radiologic signs of knee osteoarthritis were observed.
目的: 本研究的目的是评估肌肉力量与膝关节症状 (疼痛、僵硬和功能受限) 之间的相关性，而不管是否存在放射学膝关节骨关节炎 (RKOA) 在社区居住的老年人。 患者和方法: 本横断面研究使用来自 Namgaram-2 队列的数据。Namgaram-2 队列由居住在三个农村社区的参与者组成。纳入此类参与者进行与年龄相关的肌肉骨骼疾病 (包括膝骨关节炎、骨质疏松症和肌肉减少症) 导致的活动受限研究。西安大略和麦克马斯特大学骨关节炎指数 (WOMAC) 是下肢关节炎患者的健康评估工具，用于评估健康相关生活质量 (HRQOL)。通过膝关节力量 (使用等速测力计) 和手握力测量肌肉力量。 结果: Kallgren-Lawrence (K/L) 分级 <2 级的 WOMAC 疼痛与年龄、握力、营养状况、膝关节伸直 180 峰值力矩相关。K/L ≥ 2 级的 WOMAC 疼痛与年龄、营养状况和膝关节伸直 60 峰力矩相关。K/L 级 <2 的 WOMAC 僵硬度与有配偶、营养状况和膝关节伸展 60 峰值扭矩相关。K/L 级 ≥ 2 的 WOMAC 刚度与伸膝 60 峰力矩相关。K/L 级 <2 的 WOMAC 功能与年龄、握力、骨质疏松、营养状况和膝关节伸展 180 峰值力矩相关。K/L ≥ 2 级的 WOMAC 功能与年龄、营养状况、伸膝 60 峰力矩相关。 结论: 无论是否观察到膝关节骨性关节炎的影像学征象，通过握力和伸膝测量的肌力与膝关节症状患者的 WOMAC 评分在统计学上显著相关。
METHODS:Purpose To determine outcomes of transphyseal ACL reconstruction using a living parental hamstring tendon allograft in a consecutive series of 100 children. Methods One hundred consecutive juveniles undergoing ACL reconstruction with a living parental hamstring allograft were recruited prospectively and reviewed 2 years after ACL reconstruction with IKDC Knee Ligament Evaluation, and KT1000 instrumented laxity testing. Skeletally immature participants obtained annual radiographs until skeletal maturity, and long leg alignment radiographs at 2 years. Radiographic Posterior tibial slope was recorded. Results Of 100 juveniles, the median age was 14 years (range 8–16) and 68% male. At surgery, 30 juveniles were graded Tanner 1 or 2, 21 were Tanner 3 and 49 were Tanner 4 or 5. There were no cases of iatrogenic physeal injury or leg length discrepancy on long leg radiographs at 2 years, despite a median increase in height of 8 cm. Twelve patients had an ACL graft rupture and 9 had a contralateral ACL injury. Of those without further ACL injury, 82% returned to competitive sports, IKDC ligament evaluation was normal in 52% and nearly normal in 48%. The median side to side difference on manual maximum testing with the KT1000 was 2 mm (range − 1 to 5). A radiographic PTS of 12° or more was observed in 49%. Conclusions ACL reconstruction in the juvenile with living parental hamstring tendon allograft is a viable procedure associated with excellent clinical stability, patient-reported outcomes and return to sport over 2 years. Further ACL injury to the reconstructed and the contralateral knee remains a significant risk, with identical prevalence observed between the reconstructed and contralateral ACL between 12 and 24 months after surgery. Level of evidence III (Cohort Study).
METHODS:Purpose The purpose of the study was to investigate the biomechanics of walking and of the knee joint in the acute phase of ACL injury. Methods We examined 18 patients with acute ACL injuries and 20 healthy adults as controls. The biomechanics of the knee joint and of walking was assessed by 5 inertial sensors fixed with special cuffs to the lower back, the lower third of the thigh, and the lower third of the shank of the right and left legs. The movements and temporal characteristics were recorded while the subject was walking 10 m at a comfortable pace. Based on the results of examination, the patients were divided into two groups: with severe function impairment (6 patients) and with moderate function impairment (12 patients). Results It was found that in the first days post-trauma, not only the knee function was reduced, but the function of the entire lower limb as well. This led to a functional asymmetry. The kinematics of movements in the joints changed in accordance with slower walking. The walking became not only slower, but it was also associated with a decreased impact load in the weight acceptance phase. At later dates, the functional impairments were less pronounced. The total range of flexion motion did not exceed 20 degrees in the first group and 55 degrees in the second one. The injured joint developed functional immobilization within the first days post-injury. This was a guarding response by additional muscle strain to prevent unusual and limit physiological movements in the knee joint. The movements in the knee joint while walking were of small amplitude, rocking, and occurred only under load. The amplitude of the main flexion in the swing phase was reduced. Conclusion The stage of an ACL injury should be assessed not only based on the time post-trauma, but also taking account of the functional parameter—the knee range of flexion while walking. According to our findings, the only factor that had influenced the functional condition of the KJ was the duration of joint immobilization after trauma.
METHODS:Purpose Numerous techniques have been described for the tibial-sided graft preparation in anterior cruciate ligament (ACL) reconstruction. The use of less suture material for graft preparation is thought to improve ingrowth and to reduce the risk for infection. At the same time, the suture construct should be strong enough to resist the surgeon’s pull during tensioning of the transplant. Methods In total, 39 fresh-frozen procine deep flexor tendons were used and prepared as four-strand grafts. In the three-suture group ( n = 19), graft preparation was performed using three tibial-sided sutures, with each tendon end sutured separately. In the one-suture group ( n = 20), a modified graft preparation using only one tibial-sided suture was applied. Each sample underwent load-to-failure testing ( N _max) after cyclic pre-loading. To estimate intraoperative tension forces acting on the tibial-sided suture constructs, the maximal tension force of 26 volunteers on such a construct was measured using a load cell. Results The biomechanical testing of the two different suture constructs showed a significantly higher load-to-failure for the three-suture group (711 N ± 91 N) compared to the one-suture group (347 N ± 24 N) ( p = 0.0001). In both groups, the mode of failure was a tear of the suture in all samples. A failure of the suture–tendon interface was not observed in any case. The median maximal tension force on the construct applied by the 26 volunteers was 134 N (range 73–182 N). Conclusion The presented single-suture tendon graft preparation resisted to smaller failure loads than the conventional three-suture technique. However, no failures in the suture–tendon interface were seen and the failure loads observed were far beyond the tension forces that can be expected intraoperatively. Hence, the single-suture graft preparation technique may be a valuable alternative to the conventional technique.