PDF(Pubmed)
Abstract：
UNASSIGNED: Mechanical alignment of the lower limbs has been suggested to cause abnormal uneven loading across the compartments at the knee, but its contribution to the initiation and progression of arthritis remains controversial. This study aimed to establish whether malalignment of the lower limb after trauma is associated with worsened arthritis scores in the theoretically overloaded compartment, and if arthritis scores continuously correlate with the degree of malalignment and time with deformity.
UNASSIGNED: After screening 1160 X-rays, 60 patients were identified with long-leg radiographs > 2 years after fracture. Measurement of mechanical axis deviation (MAD) divided into groups of varus malalignment (n = 16, >16 mm), valgus (n = 25, <0 mm), and normal alignment (n = 19). Alignment and bilateral knee compartmental arthritis scores were recorded by three clinicians, compared via analysis of variance and assessed with linear regression against time since injury using MAD as a covariate.
UNASSIGNED: In varus and valgus malalignment, there was a greater mean arthritis score in the \"overloaded\" compartment compared to the contralateral side, with varus medial Osteoarthritis Research Society International (OARSI) scores 5.17 ± 2.91 vs 3.50 ± 2.72 (P = 0.006) and Kellegren-Lawrence scores 2.65 ± 1.19 vs 1.79 ± 1.24 (P ≤ 0.001). In a linear regression model, OARSI arthritis score was significantly associated with absolute MAD (0.6/10 mm MAD, P < 0.001) and time (0.7/decade, P ≤ 0.001).
UNASSIGNED: Malalignment consistently results in more advanced arthritis scores in the overloaded compartment, most likely related to abnormal loading across the knee. Severity of arthritis using OARSI grading continuously correlates with degree of malalignment and time with deformity after post-traumatic malunion.
UNASSIGNED: After screening 1160 X-rays, 60 patients were identified with long-leg radiographs > 2 years after fracture. Measurement of mechanical axis deviation (MAD) divided into groups of varus malalignment (n = 16, >16 mm), valgus (n = 25, <0 mm), and normal alignment (n = 19). Alignment and bilateral knee compartmental arthritis scores were recorded by three clinicians, compared via analysis of variance and assessed with linear regression against time since injury using MAD as a covariate.
UNASSIGNED: In varus and valgus malalignment, there was a greater mean arthritis score in the \"overloaded\" compartment compared to the contralateral side, with varus medial Osteoarthritis Research Society International (OARSI) scores 5.17 ± 2.91 vs 3.50 ± 2.72 (P = 0.006) and Kellegren-Lawrence scores 2.65 ± 1.19 vs 1.79 ± 1.24 (P ≤ 0.001). In a linear regression model, OARSI arthritis score was significantly associated with absolute MAD (0.6/10 mm MAD, P < 0.001) and time (0.7/decade, P ≤ 0.001).
UNASSIGNED: Malalignment consistently results in more advanced arthritis scores in the overloaded compartment, most likely related to abnormal loading across the knee. Severity of arthritis using OARSI grading continuously correlates with degree of malalignment and time with deformity after post-traumatic malunion.
摘要：
■有人建议对下肢进行机械对齐，会导致膝盖隔室的异常不均匀负荷，但它对关节炎的开始和进展的贡献仍存在争议。这项研究旨在确定创伤后下肢排列不良是否与理论上过载室中关节炎评分恶化有关。如果关节炎评分与畸形的程度和时间持续相关。
■筛选1160X射线后，60例患者在骨折后>2年长腿X光片。测量机械轴偏差（MAD），分为内翻错位组（n=16，>16mm），外翻（n=25，<0mm），和正常对齐（n=19）。三名临床医生记录了对准和双侧膝关节室性关节炎评分，通过方差分析进行比较，并使用MAD作为协变量对损伤后时间进行线性回归评估。
■在内翻和外翻畸形中，与对侧相比，“超负荷”隔室的平均关节炎评分更高，内翻骨性关节炎国际研究协会（OARSI）评分为5.17±2.91vs3.50±2.72（P=0.006），Kellegren-Lawrence评分为2.65±1.19vs1.79±1.24（P≤0.001）。在线性回归模型中，OARSI关节炎评分与绝对MAD显著相关（0.6/10mmMAD，P<0.001）和时间（0.7/decade，P≤0.001)。
■不对齐始终导致超负荷室中更晚期的关节炎评分，最有可能与膝盖上的异常负荷有关。使用OARSI分级的关节炎严重程度与创伤后不愈合后的畸形程度和时间相关。
■筛选1160X射线后，60例患者在骨折后>2年长腿X光片。测量机械轴偏差（MAD），分为内翻错位组（n=16，>16mm），外翻（n=25，<0mm），和正常对齐（n=19）。三名临床医生记录了对准和双侧膝关节室性关节炎评分，通过方差分析进行比较，并使用MAD作为协变量对损伤后时间进行线性回归评估。
■在内翻和外翻畸形中，与对侧相比，“超负荷”隔室的平均关节炎评分更高，内翻骨性关节炎国际研究协会（OARSI）评分为5.17±2.91vs3.50±2.72（P=0.006），Kellegren-Lawrence评分为2.65±1.19vs1.79±1.24（P≤0.001）。在线性回归模型中，OARSI关节炎评分与绝对MAD显著相关（0.6/10mmMAD，P<0.001）和时间（0.7/decade，P≤0.001)。
■不对齐始终导致超负荷室中更晚期的关节炎评分，最有可能与膝盖上的异常负荷有关。使用OARSI分级的关节炎严重程度与创伤后不愈合后的畸形程度和时间相关。
