Travmatologiâ i Ortopediâ Rossii (Sep 2016)
Gender features of functional state of musculoskeletal system in patients with coxarthrosis
Abstract
Purpose of the study - a comparative quantitative evaluation of regional circulation state, the degree of reducing femoral and leg contractility, as well as gait disorders in male and female patients with coxarthrosis. Material and methods. The patients with stages 1, 2, and 3 coxarthrosis were examined. The mean age of female group was 47±0.7 years, that of male one - 37±1,4 years, the number of observations was 314 and 99 persons, respectively. Arterial blood pressure (ABP), locomotion rate and the increase in heart rate during walking were determined in the patients, as well as walking time parameters, distribution of foot part loading statically and dynamically (DiaSled-Scan complex), the maximum moment of strength of femoral and leg anterior and posterior muscle groups. Linear blood flow rate in magistral arteries was determined by Doppler ultrasonography. Laser Doppler flowmetry of skin anterior surface of the leg middle third, and the dorsal surface of both limb feet (BLF-21 device of Transonic Systems, uSA) was used for capillary blood flow evaluation. Results. More rapid age-related increase in ABP and decrease in capillary blood flow rate in limb skin integuments for Stage 2 and 3 of the disease were observed in female patients above 45 years. As for Stage 3 of the disease in female patients, the maximum load of the foot support (bearing) surface when standing and walking was reduced. Limb muscle strength in female patients is twice lower than that in male patients. As far as the disease progressed, more rapid decrease in the contractility of femoral muscles was noted compared to that of the leg. The compensatory increase in muscle strength of the leg was observed for Stage 1 of the disease and after the performed complex conservative treatment. Walking speed in the patients decreased with their age increasing, and the pulse value of locomotion increased with the disease stage increasing. Conclusion. More frequent involvement of the hip in women may be partially explained by the increase in the relative number of the gender representatives in the older age groups. Hypertension in female patients with coxarthrosis is a compensatory response related to microcirculation aggravation in limb tissues, the dynamometric parameters of femoral muscles in female patients are much lower, and the load of foot support surface is less.
Keywords
