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在一个基本无骨关节炎的队列中,半月板撕裂作为骨关节炎的危险因素:一项横断面研究。

Meniscal tear as an osteoarthritis risk factor in a largely non-osteoarthritic cohort: a cross-sectional study.

作者信息

Ding Changhai, Martel-Pelletier Johanne, Pelletier Jean-Pierre, Abram François, Raynauld Jean-Pierre, Cicuttini Flavia, Jones Graeme

机构信息

Menzies Research Institute, University of Tasmania, Hobart, Australia.

出版信息

J Rheumatol. 2007 Apr;34(4):776-84. Epub 2007 Mar 15.

Abstract

OBJECTIVE

To examine the associations between meniscal tear, knee structure, osteoarthritis (OA) risk factors, radiographic change, and symptoms in a largely non-osteoarthritic cohort.

METHODS

This cross-sectional study included 294 subjects with mean age 47 (SD 6) years, body mass index (BMI) 28 (SD 5), and 58% were female. Meniscal tear, knee cartilage defect score, quantitative tibial and femoral cartilage volume, and tibial plateau bone area were determined using T1-weighted fat saturated magnetic resonance images.

RESULTS

In multivariable analysis, prevalence of meniscal tear was significantly associated with age (OR 1.06 to 1.12/year, all p < 0.05), BMI (OR 1.06 to 1.11/kg/m(2), all p < 0.05 with the exception of the lateral anterior horn), sex (women vs men: OR 4.14 to 4.23, p < 0.01 at the medial and lateral meniscal body site), and family history of OA (OR 1.97 to 2.01, p < 0.05 at the lateral meniscal anterior and posterior horns). Meniscal tear was associated with a higher tibiofemoral cartilage defect score at lateral body and all medial sites, lower tibial and femoral cartilage volume at the lateral compartment, markedly higher prevalent radiographic OA at medial compartment, and greater tibial bone area. Moreover, meniscal tear at the lateral posterior and anterior horns was significantly associated with WOMAC pain, stiffness, and function scores.

CONCLUSION

Meniscal tear at specific sites shares risk factors with knee OA. Importantly, meniscal tear is associated with cartilage defect, loss of cartilage volume, alteration in bone size, and prevalence of radiographic OA, suggesting that meniscal tear in non-OA subjects appears to be an early event in the disease process, and may be a risk factor for knee cartilage damage and articular structural changes.

摘要

目的

在一个基本无骨关节炎的队列中,研究半月板撕裂、膝关节结构、骨关节炎(OA)危险因素、影像学改变和症状之间的关联。

方法

这项横断面研究纳入了294名受试者,平均年龄47(标准差6)岁,体重指数(BMI)为28(标准差5),58%为女性。使用T1加权脂肪饱和磁共振成像确定半月板撕裂、膝关节软骨缺损评分、胫股软骨定量体积和胫骨平台骨面积。

结果

在多变量分析中,半月板撕裂的患病率与年龄(比值比1.06至1.12/年,所有p<0.05)、BMI(比值比1.06至1.11/kg/m²,除外侧前角外所有p<0.05)、性别(女性与男性相比:内侧和外侧半月板体部比值比4.14至4.23,p<0.01)以及OA家族史(外侧半月板前后角比值比1.97至2.01,p<0.05)显著相关。半月板撕裂与外侧体部和所有内侧部位较高的胫股软骨缺损评分、外侧间室较低的胫股软骨体积、内侧间室明显更高的影像学OA患病率以及更大的胫骨骨面积相关。此外,外侧后角和前角的半月板撕裂与WOMAC疼痛、僵硬和功能评分显著相关。

结论

特定部位的半月板撕裂与膝关节OA具有共同的危险因素。重要的是,半月板撕裂与软骨缺损、软骨体积丢失、骨大小改变以及影像学OA患病率相关,这表明非OA受试者中的半月板撕裂似乎是疾病过程中的早期事件,可能是膝关节软骨损伤和关节结构改变的危险因素。

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