内側型変形性膝関節症における Trendelenburg Sign の有無

抄録

In most cases, the Trendelenburg sign is positive when there is a weakness in the abductor muscles resulting in the weakness of the hip, as in neurological disorders and or hip disorders.
In 1997, Vasudevan P. N. et. al. reported that the medial deviation of the mechanical axis of the leg may cause a positive Trendelenburg sign. They said that if the hip is abducted in compensation for a varus deformity below the hip, the trochanter rotates proximally, thus effectively shortening and weakening the abductor muscles.
From this we can deduce that the Trendelenburg sign can be detected if there is a medial shift of the mechanical axis of the leg because of the deformity of the femur and tibia with primary osteoarthritis of the knee.
We selected 15 patients, studying a total of 30 legs. No neurological or hip disorders were presented in all participants. We conducted Trendelenburg sign tests and manual muscle tests (MMT) of the hip abductor muscles, while studying their knee complaints and plane X-rays.
7 legs had no complaints of the knee, showed negative Trendelenburg sign, and had normal (5) MMT scores. The other 23 legs had knee complaints and showed osteoarthritis on their X-rays. The Trendelenburg sign was present in the legs of 21 of the 23 patients. The MMT score was also good (4) in all of these legs.
These results suggest that the Trendelenburg sign may be positive in the medial shift of the mechanical axis of the les with primary osteoarthritis of a particular knee with problematic symptoms.