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膝关节骨关节炎的局部发病可在 10 年前的 MRI 影像学检查结果中预测。

Localized development of knee osteoarthritis can be predicted from MR imaging findings a decade earlier.

机构信息

Department of Radiology, Leiden University Medical Center, Albinusdreef 2, 2300 RC Leiden, The Netherlands.

出版信息

Radiology. 2010 Aug;256(2):536-46. doi: 10.1148/radiol.10090683. Epub 2010 Jun 29.

Abstract

PURPOSE

To define localized development of knee osteoarthritis (OA) that arises from anterior cruciate ligament (ACL) and meniscal injuries identified at magnetic resonance (MR) imaging performed a decade ago and the subsequent management of those findings in patients with subacute knee symptoms.

MATERIALS AND METHODS

The present study was approved by local medical ethics review boards, and written informed consent was obtained. Three hundred twenty-six patients (mean age, 42 years; 108 female) from a previously reported series of 855 patients were followed up with regard to the effect of MR imaging-guided treatment for subacute knee problems. The mean follow-up period was 10 years. Initial findings and treatment were compared with the follow-up radiograph and 3.0-T MR image findings. Odds ratios (ORs), with corresponding 95% confidence intervals, were used to identify the effects between variables.

RESULTS

Patients with ACL ruptures had an increased risk of developing joint space narrowing (JSN), cartilaginous defects, osteophytes, bone marrow lesions, and subchondral cysts medially or laterally (OR, 2.4-9.8). Patients with medial meniscal tears had an increased risk of developing JSN, cartilaginous defects, osteophytes, and bone marrow lesions medially (OR, 2.0-15.3). Patients with lateral meniscal tears had an increased risk of developing JSN, cartilaginous defects, osteophytes, bone marrow lesions, and subchondral cysts laterally (OR, 2.1-10.5). Meniscectomy had no effect on the risk of developing OA.

CONCLUSION

Localized knee OA developed from risk factors identified from the findings of MR imaging performed a decade ago in patients with subacute knee symptoms and did not depend on the surgical treatment of those findings.

摘要

目的

定义膝关节骨关节炎(OA)的局限性发展,这种发展源自于十年前磁共振(MR)成像中发现的前交叉韧带(ACL)和半月板损伤,以及随后对亚急性膝关节症状患者这些发现的处理。

材料和方法

本研究得到了当地医学伦理审查委员会的批准,并获得了书面知情同意。从之前报道的 855 例患者系列中,有 326 例患者(平均年龄 42 岁,女性 108 例)接受了亚急性膝关节问题的 MR 成像引导治疗效果的随访。平均随访时间为 10 年。将初始发现和治疗与随访 X 线片和 3.0-T MR 图像发现进行比较。使用比值比(OR)及其 95%置信区间来确定变量之间的影响。

结果

ACL 断裂患者发生关节间隙狭窄(JSN)、软骨缺损、骨赘、骨髓病变和内侧或外侧骨软骨下囊肿的风险增加(OR 2.4-9.8)。内侧半月板撕裂患者发生 JSN、软骨缺损、骨赘和内侧骨髓病变的风险增加(OR 2.0-15.3)。外侧半月板撕裂患者发生 JSN、软骨缺损、骨赘、骨髓病变和外侧骨软骨下囊肿的风险增加(OR 2.1-10.5)。半月板切除术对发生 OA 的风险没有影响。

结论

在亚急性膝关节症状患者中,从十年前的 MR 成像结果中发现的危险因素导致局限性膝关节 OA 的发展,而不依赖于这些发现的手术治疗。

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