Wang Y, Ding C, Wluka A E, Davis S, Ebeling P R, Jones G, Cicuttini F M
Department of Epidemiology and Preventive Medicine, Monash University, Central and Eastern Clinical School, Alfred Hospital, Melbourne, Vic. 3004, Australia.
Rheumatology (Oxford). 2006 Jan;45(1):79-84. doi: 10.1093/rheumatology/kei108. Epub 2005 Sep 27.
Cartilage defects are present in subjects with knee osteoarthritis (OA). Although they are often present in healthy subjects, there is little data on the natural history of cartilage defects. The aim of this study was to examine the change in cartilage defects over 2 yr and to identify factors associated with this change.
One hundred and twenty-four healthy subjects underwent magnetic resonance imaging of their dominant knee at baseline and follow-up. Cartilage defects were scored (0-4) at five sites. Bone size was determined at medial and lateral tibial plateau and patella. Height, weight, body mass index and physical activity were measured by standard protocols.
Eighty-six subjects completed the study. The mean cartilage defect score of each tibiofemoral compartment increased over time. However, medial and lateral tibiofemoral defect score decreased in 5% of the subjects. Cartilage defects were more likely to progress in males than females in each individual compartment (P<0.001 for medial tibiofemoral, P=0.005 for lateral tibiofemoral and P=0.01 for patellar cartilage). Baseline cartilage defect score was negatively associated with the progression of cartilage defects in each compartment (all P<0.001).
Although knee cartilage defects progressed over time in the majority of normal subjects, those of the highest severity tended to regress. Male gender and baseline cartilage defect score were the main factors associated with the progression of cartilage defects. Larger studies will be required to identify factors associated with the progression and regression of lesions.
膝关节骨关节炎（OA）患者存在软骨缺损。尽管健康受试者中也常出现软骨缺损，但关于软骨缺损自然史的数据很少。本研究的目的是检查2年内软骨缺损的变化，并确定与这种变化相关的因素。
124名健康受试者在基线和随访时对其优势膝关节进行磁共振成像。在五个部位对软骨缺损进行评分（0 - 4分）。测定胫骨内侧和外侧平台以及髌骨的骨大小。通过标准方案测量身高、体重、体重指数和身体活动情况。
86名受试者完成了研究。每个胫股关节间室的平均软骨缺损评分随时间增加。然而，5%的受试者胫股关节内侧和外侧的缺损评分下降。在各个关节间室中，男性的软骨缺损比女性更易进展（胫股关节内侧P<0.001，胫股关节外侧P = 0.005，髌软骨P = 0.01）。基线软骨缺损评分与每个关节间室的软骨缺损进展呈负相关（所有P<0.001）。
尽管大多数正常受试者的膝关节软骨缺损随时间进展，但最严重的缺损往往会有所改善。男性性别和基线软骨缺损评分是与软骨缺损进展相关的主要因素。需要进行更大规模的研究来确定与病变进展和改善相关的因素。
