Cicuttini F M, Wluka A E, Wang Y, Stuckey S L
Monash University Medical School and Alfred Hospital, Prahran, Victoria, Australia.
Arthritis Rheum. 2004 Jan;50(1):94-7. doi: 10.1002/art.11483.
Despite the increasing interest in knee cartilage volume as an outcome measure in studies of osteoarthritis (OA), it is unclear what components of knee cartilage will be most useful as markers of structural change in the tibiofemoral joint. This study was undertaken to longitudinally compare changes in femoral and tibial cartilage volume in patients with OA.
One hundred seventeen patients with knee OA (58.1% women; mean +/- SD age 63.7 +/- 10.2 years) were examined. Femoral and tibial cartilage volumes (medial and lateral tibiofemoral joints) were determined from T1-weighted fat-saturated magnetic resonance images of the knee from coronal views.
The study population was followed up for a mean +/- SD of 1.9 +/- 0.2 years. In the medial tibiofemoral joint, the mean +/- SD loss of cartilage was 0.15 +/- 0.30 ml/year for femoral cartilage and 0.10 +/- 0.25 ml/year for tibial cartilage. In the lateral tibiofemoral joint, the average loss was 0.15 +/- 0.22 and 0.12 +/- 0.16 ml/year for femoral and tibial cartilage, respectively. There was a significant correlation between the degree of loss of tibial cartilage and the degree of loss of femoral cartilage, in both tibiofemoral joints (r = 0.81, P < 0.001 at the medial tibiofemoral joint; r = 0.71, P < 0.001 at the lateral tibiofemoral joint).
Longitudinal changes in tibial cartilage and those in femoral cartilage are strongly related to one another. This suggests that in tibiofemoral disease, measuring tibial cartilage alone may be adequate, given the facts that measurements of the total femoral cartilage are less reproducible and there are difficulties inherent in identifying the most appropriate component of femoral cartilage to measure.
尽管在骨关节炎(OA)研究中,作为结局指标的膝关节软骨体积越来越受到关注,但尚不清楚膝关节软骨的哪些成分作为胫股关节结构变化的标志物最为有用。本研究旨在纵向比较OA患者股骨和胫骨软骨体积的变化。
对117例膝OA患者(女性占58.1%;平均±标准差年龄63.7±10.2岁)进行检查。通过膝关节冠状面的T1加权脂肪饱和磁共振图像确定股骨和胫骨软骨体积(内侧和外侧胫股关节)。
研究人群的平均随访时间为1.9±0.2年。在内侧胫股关节,股骨软骨的平均±标准差软骨丢失量为0.15±0.30 ml/年,胫骨软骨为0.10±0.25 ml/年。在外侧胫股关节,股骨和胫骨软骨的平均丢失量分别为0.15±0.22和0.12±0.16 ml/年。在两个胫股关节中,胫骨软骨丢失程度与股骨软骨丢失程度之间均存在显著相关性(在内侧胫股关节,r = 0.81,P < 0.001;在外侧胫股关节,r = 0.71,P < 0.001)。
胫骨软骨和股骨软骨的纵向变化密切相关。这表明,在胫股关节疾病中,鉴于测量整个股骨软骨的可重复性较差且确定要测量的股骨软骨最合适成分存在固有困难,仅测量胫骨软骨可能就足够了。