L’effet de la suppression de la douleur sur la biomécanique tridimensionnelle du genou et de la cheville chez des patients gonarthrosiques
Objectives To verify whether or not pain suppression in patients who have knee osteoarthritis have an immediate effect on three-dimensional biomechanics of the knee and the ankle while walking on an instrumented treadmill.  Methods  Nine patients with painful patellofemoral osteoarthritis, with or without femoro-tibial osteoarthritis, who reported pain intensity ≥ 3/10 on a Numeric Rating Scale (NRS) before the test, were included in this study. Biomechanical assessment of the knee/ankle along with a regularly NRS evaluation were conducted before and 15 min after pain relief induced by an intra-articular injection of 5 mL lidocaine (1%). All participants were assessed with the KneeKGTM system.  Results All participants exhibited reduction in pain after lidocaine injection. They were grouped according to the magnitude of pain reduction: minimal (N = 1), much improved (N = 4), and substantial reduction (N = 4). Biomechanics changes in the knee or in the ankle were found in all subjects, but in a different plane from one subject to another. The participant who had minimal reduction in pain post injection demonstrated changes in sagittal and frontal planes at the knee, and three-dimensional changes at the ankle. In the much improved group at the knee, one subject demonstrated three-dimensional changes, another subject had changes in two planes (frontal and transverse) and only two subjects had changes in the frontal plane. At the ankle, all subjects had changes in at least two planes (frontal and transverse). One subject in the substantial reduction group demonstrated changes in two planes at the knee (frontal and transverse) and the other subjects had changes in only one plane (sagittal, frontal or transverse). In this group, all subjects had changes in at least two plans at the ankle.  Conclusion Reduction in pain has an effect 15 min after injection on three-dimensional kinematics of the knee and ankle during walking. All participants demonstrated kinematic changes at least in one anatomical plane at both joints.
KneeKG Pain Knee osteoarthritis Kinematic Ankle