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横断面研究中内外侧髁骨密度比值:内侧膝关节骨关节炎严重程度的一个潜在标志物。

Medial versus lateral condyle bone mineral density ratios in a cross-sectional study: a potential marker for medial knee osteoarthritis severity.

机构信息

Department of Orthopaedic Surgery, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan.

出版信息

Arthritis Care Res (Hoboken). 2012 Jul;64(7):1036-45. doi: 10.1002/acr.21651.

Abstract

OBJECTIVE

To assess the association of bone mineral density (BMD) of the femoral and tibial condyles with knee pain and disease severity in women with symptomatic medial knee osteoarthritis (OA).

METHODS

We enrolled 192 women (ages 41-90 years) between April 2007 and March 2011. The subjects were divided into 2 groups according to joint space narrowing (JSN) on weight-bearing radiographs. BMD of the lumbar spine, proximal femur, and knee condyles was measured. Medial and lateral condyle BMDs of the femur and tibia as well as the medial versus lateral condyle BMD ratios were measured.

RESULTS

Mean medial condyle BMDs, medial versus lateral condyle BMD ratios, and visual analog scale (VAS) pain in both the femur and the tibia were higher in the obliteration group compared with the narrowing group (P < 0.001 for all). A significant positive correlation was observed between the femoral and tibial condyles in the following parameters: medial condyle BMDs, lateral condyle BMDs, and medial versus lateral condyle BMD ratios (r = 0.791-0.844). In both the femur and the tibia, medial versus lateral condyle BMD ratios had significant positive correlations with femorotibial angle, medial osteophytes, lateral osteophytes, medial JSN, and VAS pain, and had significant negative correlations with the Knee Society pain and function scores.

CONCLUSION

Although this study was a cross-sectional study, the femoral and tibial medial versus lateral condyle BMD ratios increased with more severe knee pain and might be a potential marker for monitoring disease severity in women with symptomatic medial knee OA.

摘要

目的

评估女性症状性内侧膝关节骨关节炎(OA)患者股骨和胫骨髁骨密度(BMD)与膝关节疼痛和疾病严重程度的相关性。

方法

我们于 2007 年 4 月至 2011 年 3 月间招募了 192 名年龄在 41-90 岁之间的女性。根据负重位 X 线片上的关节间隙变窄(JSN),将受试者分为 2 组。测量腰椎、股骨近端和膝关节髁骨的 BMD。测量股骨和胫骨的内侧和外侧髁骨 BMD 以及内侧与外侧髁骨 BMD 比值。

结果

与狭窄组相比,闭塞组的股骨和胫骨内侧髁骨 BMD 较高,内侧与外侧髁骨 BMD 比值和视觉模拟评分(VAS)疼痛较高(所有 P<0.001)。在以下参数中,股骨和胫骨的内侧和外侧髁骨之间存在显著的正相关:内侧髁骨 BMD、外侧髁骨 BMD 和内侧与外侧髁骨 BMD 比值(r=0.791-0.844)。在股骨和胫骨中,内侧与外侧髁骨 BMD 比值与股胫角、内侧骨赘、外侧骨赘、内侧 JSN 和 VAS 疼痛呈显著正相关,与膝关节协会疼痛和功能评分呈显著负相关。

结论

尽管这是一项横断面研究,但股骨和胫骨的内侧与外侧髁骨 BMD 比值随膝关节疼痛加重而增加,可能是监测女性症状性内侧膝关节 OA 疾病严重程度的潜在标志物。

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