Marticke Julia K, Hösselbarth Anja, Hoffmeier Konrad L, Marintschev Ivan, Otto Steffi, Lange Matthias, Plettenberg Holger K W, Spahn Gunter, Hofmann Gunther O
Department of Traumatology and Orthopaedic Surgery, Friedrich Schiller University of Jena and Trauma Centre Halle (Saale), Germany.
Clin Biomech (Bristol). 2010 May;25(4):332-40. doi: 10.1016/j.clinbiomech.2009.12.008. Epub 2010 Jan 21.
Characteristic changes in cartilage of human knee joints with different degrees of osteoarthritis (OA) have been investigated by visual, biophotonical and biomechanical examination. Knowledge about the cartilage composition and changes during the development of OA is important for diagnostic decisions and understanding the pathogenesis of OA.
Thirty two patients with severe knee OA received endoprosthetic replacement. During surgical intervention cartilage specimen were harvested from defined surface areas of the joints. The degree of cartilage defects was classified visually (ICRS Grade: International Cartilage Repair Society), biophotonically (NIRS: near infrared spectroscopy) and biomechanically (Young's Modulus). To characterise links between the investigated parameters the Spearman's rank correlation coefficient was used.
Significant negative correlations were found between visual macroscopic degree of degeneration (ICRS Grade) and biophotonic characteristics (NIRS) (rho=-0.467) or cartilage stiffness (Young's Modulus) (rho=-0.501). Between NIRS and Young's Modulus significant positive correlation of rho=0.535 was detected.
Visual, biophotonic and biomechanical properties of cartilage reveal strong correlations in all degrees of cartilage defects in patients with severe OA. According to these results, we indicate that an objective, non-invasive and non-destructive measurement of cartilage properties during open and arthroscopic knee surgery is possible by NIRS and provide a novel tool to evaluate disease intervention and treatment.
通过视觉、生物光子学和生物力学检查,对不同程度骨关节炎(OA)患者膝关节软骨的特征性变化进行了研究。了解OA发展过程中软骨的组成和变化对于诊断决策和理解OA的发病机制很重要。
32例重度膝关节OA患者接受了人工关节置换。在手术干预期间,从关节的特定表面区域采集软骨标本。软骨缺损程度通过视觉(ICRS分级:国际软骨修复协会)、生物光子学(近红外光谱法,NIRS)和生物力学(杨氏模量)进行分类。为了表征所研究参数之间的联系,使用了斯皮尔曼等级相关系数。
在视觉宏观退变程度(ICRS分级)与生物光子学特征(NIRS)(rho = -0.467)或软骨硬度(杨氏模量)(rho = -0.501)之间发现显著负相关。在NIRS与杨氏模量之间检测到显著正相关,rho = 0.535。
在重度OA患者中,软骨的视觉、生物光子学和生物力学特性在所有程度的软骨缺损中均显示出强相关性。根据这些结果,我们表明在开放和关节镜膝关节手术期间,通过NIRS对软骨特性进行客观、非侵入性和非破坏性测量是可行的,并提供了一种评估疾病干预和治疗的新工具。