Department of Orthopaedic Surgery, Copenhagen University Hospital of Hvidovre, Hvidovre, Denmark.
Skeletal Radiol. 2010 Sep;39(9):859-66. doi: 10.1007/s00256-009-0856-x. Epub 2010 Jan 30.
The aims of the present study were threefold: to examine the distribution of knee joint osteoarthritis in a large, standardized radiological study; to examine the relationships between self reported knee pain and radiological OA; and to examine the natural history of radio-morphological change over age in individuals without radiological features of OA.
The Copenhagen Osteoarthritis Study - COS is a substudy of the Copenhagen City Heart Study, a longitudinal regional health survey. From the third inclusion of the CCHS (1992-1994) 4,151 subjects were selected for subsequent standardized radiography of the pelvis, the knees, the hands, the wrists, and the lumbar spine. Images were analyzed and knee joint osteoarthritis (OA) was classified according to the radiographic atlas of Kellgren and Lawrence. Joint space width (JSW) was measured at three sites within both the medial and the lateral compartment.
For the entire cohort the prevalence of radiological knee joint OA of all grades was 38.7% for men and 44.2% for women. Age stratification documented increasing knee joint OA both in regard to prevalence and morphological severity. Knee pain was universally correlated to the Kellgren and Lawrence severity of OA. In a subgroup with no features of radiological OA, a significant and linear decline in JSW with increasing age was found.
We found a clear relationship between self-reported knee pain and radiological osteoarthritis. Pain was proportionally related to the severity of change. We also demonstrated a significant diminishing of joint space width with increasing age in individuals without apparent radiological degeneration.
本研究旨在实现三个目标：在一项大型标准化影像学研究中检验膝关节骨关节炎的分布情况；检验膝关节疼痛与影像学骨关节炎之间的关系；以及检验无影像学骨关节炎特征的个体中关节形态放射学改变随年龄的自然史。
哥本哈根骨关节炎研究（COSM）是哥本哈根城市心脏研究（CCHS）的子研究，是一项纵向区域性健康调查。从 CCHS 的第三次纳入（1992-1994 年）中，选择了 4151 名受试者进行随后的骨盆、膝关节、手部、腕部和腰椎的标准化放射摄影。对图像进行了分析，并根据 Kellgren 和 Lawrence 的放射图谱对膝关节骨关节炎（OA）进行了分类。在内侧和外侧隔室的三个部位测量了关节间隙宽度（JSW）。
对于整个队列，男性和女性的各级放射学膝关节 OA 患病率分别为 38.7%和 44.2%。年龄分层记录了膝关节 OA 在患病率和形态严重程度方面的增加。膝关节疼痛与 Kellgren 和 Lawrence 的 OA 严重程度普遍相关。在没有放射学 OA 特征的亚组中，随着年龄的增加，JSW 呈显著线性下降。
我们发现自报膝关节疼痛与放射学骨关节炎之间存在明确的关系。疼痛与变化的严重程度成比例相关。我们还证明了在没有明显放射学退行性变的个体中，关节间隙宽度随年龄的增加而显著减少。
