Davies-Tuck M L, Martel-Pelletier J, Wluka A E, Pelletier J-P, Ding C, Jones G, Davis S, Cicuttini F M
Department of Epidemiology and Preventive Medicine, Monash University, Central and Eastern Clinical School, Alfred Hospital, Melbourne, Victoria 3004, Australia.
Osteoarthritis Cartilage. 2008 Feb;16(2):268-71. doi: 10.1016/j.joca.2007.10.018.
Meniscal tears detected using magnetic resonance imaging (MRI) have been identified as a risk factor for the development and progression of Osteoarthritis, however the prevalence and significance of meniscal tears in healthy, asymptomatic adults remains to be studied. We investigated the prevalence of meniscal tears in a healthy pain free population of post-menopausal women and whether meniscal tears in this population are associated with changes in cartilage volume and defects and tibial plateau bone area over 2 years.
Fifty-seven post-menopausal women underwent MRI of their dominant knee at baseline line and approximately 2 years later to assess meniscal tears, cartilage volume, cartilage defects and tibial plateau bone area.
Forty-six percent of women had a meniscal tear in either the medial and/or lateral compartment. Women who had a tear were older (P=0.01) and had more lateral cartilage defects (P=0.02). Medial meniscal tear was associated with 103 mm(2) greater tibial plateau bone area within the medial [95% confidence of interval (CI) 6.2, 200.3; P=0.04] and a lateral meniscal tear with a 120 mm(2) greater area within the lateral compartment (95% CI 45.5, 195.2; P=0.002).
This study demonstrates that meniscal tears are common in asymptomatic post-menopausal women and that they become more common with age. Meniscal tears were also associated with greater tibial plateau bone area but not cartilage volume, providing support to the hypothesis that tibial plateau bone changes occur before significant pathological changes in cartilage. Whether increased tibial plateau bone area predisposes to an increased risk of degenerative meniscal tears or whether it is a consequence of altered biomechanical forces in relation to meniscal tear will need to be determined.
利用磁共振成像（MRI）检测出的半月板撕裂已被确定为骨关节炎发生和发展的一个风险因素，然而，健康无症状成年人中半月板撕裂的患病率及意义仍有待研究。我们调查了健康无疼痛的绝经后女性人群中半月板撕裂的患病率，以及该人群中的半月板撕裂是否与2年内软骨体积、缺损和胫骨平台骨面积的变化相关。
57名绝经后女性在基线时以及大约2年后对其优势膝关节进行MRI检查，以评估半月板撕裂、软骨体积、软骨缺损和胫骨平台骨面积。
46%的女性在内侧和/或外侧半月板有撕裂。有撕裂的女性年龄更大（P=0.01），外侧软骨缺损更多（P=0.02）。内侧半月板撕裂与内侧胫骨平台骨面积增加103平方毫米相关[95%置信区间（CI）6.2，200.3；P=0.04]，外侧半月板撕裂与外侧半月板区域增加120平方毫米相关（95%CI 45.5，195.2；P=0.002）。
本研究表明，半月板撕裂在无症状绝经后女性中很常见，且随着年龄增长更为普遍。半月板撕裂还与更大的胫骨平台骨面积相关，但与软骨体积无关，这为胫骨平台骨变化先于软骨显著病理变化发生的假说提供了支持。胫骨平台骨面积增加是导致半月板退行性撕裂风险增加的原因，还是与半月板撕裂相关的生物力学力改变所导致的结果，仍有待确定。
