Abstract
Background
Clinical observation of increased laxity has been noted in native Canadians. Comparative studies support the possible relationship between joint hypermobility and the development of osteoarthritis or other joint ailments. If joint laxity predisposes to osteoarthritis, there may be far-reaching consequences to the general Native population.
Methods
A cohort of 52 Native Canadians (NC) and 52 non-Native Canadians (NNC) were evaluated for knee laxity. All patients had no prior history of knee injury or complaints of symptoms related to knee pathology at the time of the examination. Bilateral knee examination was performed. Objective laxity was measured using the KT-1000 tensiometer. Subjective findings were also recorded.
Results
Comparison for instability between the groups (NC and NNC) revealed that the NC group had significantly greater laxity on both right and left sides for all knee ligament grading (p≤0.0001). The values for displacement during KT-1000 measurements were significantly greater in the NC group for all forces (p≤0.0001). Presence of all the following were also significantly greater in the NC group: pivot shift (p≤0.001); medial and lateral collateral ligament opening (p≤0.001); posterior cruciate drawer test (p≤0.001).
Interpretation
This prospective matched cohort reveals that there is a significant joint hypermobility in this Native Canadian population.
MeSH terms: Joint hypermobility, Native population, osteoarthritis, prospective cohort
Résmé
Contexte
La laxité ligamentaire est une condition prévalente chez les autochtones canadiens. L’hypermobilité articulaire est impliquée dans le développement de pathologies articulaires telles que l’arthrose selon certaines études cliniques. Cette population présente donc un risque plus élevé de pathologies articulaires si cette hyperlaxité est confirmée.
Méthode
Une cohorte de 52 Canadiens autochtones (CA) et une autre de 52 Canadiens non-autochtones (CNA) ont été évaluées pour la laxité ligamentaire aux genoux. Aucun patient n’avait d’antécédents de trauma aux genoux, ni de plaintes liées à une pathologie du genou au moment de l’évaluation. Nous avons procédé à un examen clinique bilatéral du genou. Nous avons mesuré la laxité ligamentaire de façon objective avec le tensiomètre KT-1000, puis effectué une évaluation subjective.
Résultats
La comparaison clinique a démontré une instabilité ligamentaire statistiquement plus significative pour tous les ligaments des genoux droit et gauche chez les Canadiens autochtones (CA) (p≤0,0001). Les résultats de déplacement avec le KT-1000 ont aussi été significativement plus élevés chez les CA pour toutes les forces testées (p≤0,0001). Les tests cliniques de stabilité ligamentaire du genou suivants ont aussi été plus fréquents chez les CA: le pivot-glissement (p≤0,001), le bâillement du ligament collatéral interne et externe (p≤0,001) et le tiroir postérieur (p≤0,001).
Interprétation
Cette étude prospective de cohorte démontre une laxité ligamentaire importante du genou chez cette population de Canadiens autochtones.
Footnotes
Study conducted at the Division of Orthopedic Surgery McGill University Health Center No financial support was received by the authors in connection with this study.
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