健康膝关节和轻度、中度及晚期放射学骨关节炎膝关节软骨形态变化率及变化敏感性：来自骨关节炎倡议 831 名参与者的结果。
Rates of change and sensitivity to change in cartilage morphology in healthy knees and in knees with mild, moderate, and end-stage radiographic osteoarthritis: results from 831 participants from the Osteoarthritis Initiative.
机构信息
Institute of Anatomy and Musculoskeletal Research, Paracelsus Medical University, Salzburg, Austria.
出版信息
Arthritis Care Res (Hoboken). 2011 Mar;63(3):311-9. doi: 10.1002/acr.20370.
OBJECTIVE
To study the longitudinal rate of (and sensitivity to) change of knee cartilage thickness across defined stages of radiographic osteoarthritis (OA), specifically healthy knees and knees with end-stage radiographic OA.
METHODS
One knee of 831 Osteoarthritis Initiative participants was examined: 112 healthy knees, without radiographic OA or risk factors for knee OA, and 719 radiographic OA knees (310 calculated Kellgren/Lawrence [K/L] grade 2, 300 calculated K/L grade 3, and 109 calculated K/L grade 4). Subregional change in thickness was assessed after segmentation of weight-bearing femorotibial cartilage at baseline and 1 year from coronal magnetic resonance imaging (MRI). Regional and ordered values (OVs) of change were compared by baseline radiographic OA status.
RESULTS
Healthy knees displayed small changes in plates and subregions (±0.7%; standardized response mean [SRM] ±0.15), with OVs being symmetrically distributed close to zero. In calculated K/L grade 2 knees, changes in cartilage thickness were small (<1%; minimal SRM -0.22) and not significantly different from healthy knees. Knees with calculated K/L grade 3 showed substantial loss of cartilage thickness (up to -2.5%; minimal SRM -0.35), with OV1 changes being significantly (P < 0.05) greater than those in healthy knees. Calculated K/L grade 4 knees displayed the largest rate of loss across radiographic OA grades (up to -3.9%; minimal SRM -0.51), with OV1 changes also significantly (P < 0.05) greater than in healthy knees.
CONCLUSION
MRI-based cartilage thickness showed high rates of loss in knees with moderate and end-stage radiographic OA, and small rates (indistinguishable from healthy knees) in mild radiographic OA. From the perspective of sensitivity to change, end-stage radiographic OA knees need not be excluded from longitudinal studies using MRI cartilage morphology as an end point.
目的
研究膝关节软骨厚度在特定的放射学骨关节炎（OA）阶段（包括健康膝关节和终末期放射学 OA 膝关节）的纵向变化率（和对变化的敏感性）。
方法
对 831 名骨关节炎倡议参与者的一只膝关节进行了检查：112 只健康膝关节，无放射学 OA 或膝关节 OA 的危险因素，719 只放射学 OA 膝关节（310 只计算 Kellgren/Lawrence [K/L] 分级 2，300 只计算 K/L 分级 3，109 只计算 K/L 分级 4）。在基线和磁共振成像（MRI）的 1 年时，通过对负重股骨胫骨软骨进行分割，评估厚度的亚区变化。根据基线放射学 OA 状况比较了区域和有序变化值（OV）。
结果
健康膝关节的板层和亚区变化较小（±0.7%；标准化反应均值[SRM] ±0.15），OV 接近对称分布于零附近。在计算的 K/L 分级 2 膝关节中，软骨厚度的变化较小（<1%；最小 SRM -0.22），与健康膝关节无显著差异。计算的 K/L 分级 3 膝关节显示出大量的软骨厚度损失（高达-2.5%；最小 SRM -0.35），OV1 变化明显大于健康膝关节（P < 0.05）。计算的 K/L 分级 4 膝关节在放射学 OA 分级中显示出最大的损失率（高达-3.9%；最小 SRM -0.51），OV1 变化也明显大于健康膝关节（P < 0.05）。
结论
基于 MRI 的软骨厚度在中晚期放射学 OA 膝关节中显示出较高的损失率，在轻度放射学 OA 膝关节中损失率较低（与健康膝关节无显著差异）。从对变化的敏感性来看，使用 MRI 软骨形态作为终点的纵向研究无需排除终末期放射学 OA 膝关节。
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