Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia.
Osteoarthritis Cartilage. 2012 Dec;20(12):1541-7. doi: 10.1016/j.joca.2012.08.026. Epub 2012 Sep 7.
To describe the natural history of knee cartilage defects, and their relationship to cartilage volume loss and risk of knee replacement in a longitudinal study of older adults.
395 randomly selected older adults (mean age 62.7 years) had magnetic resonance imaging of their right knee at baseline and approximately 2.9 years later to determine cartilage defect grade (0-4), cartilage volume, medial and lateral tibial bone size, and presence of bone marrow lesions (BMLs). Height, weight, body mass index (BMI) and radiographic osteoarthritis were measured by standard protocols.
At baseline higher grade cartilage defects (grade ≥2) were significantly associated with age, BMI, lateral tibial bone size, BMLs, and radiographic osteoarthritis. Over 2.9 years, the average defect score increased statistically significantly in all compartments; however, the majority of defects remained stable and regression of defects was rare. Baseline factors associated with increase in defect score over 2.9 years were radiographic osteoarthritis, tibial bone size, BMI and being female. In multivariate analysis, baseline cartilage defect grade predicted cartilage volume loss at the medial tibia, lateral tibia and patella over 2.9 years (β = -1.78% to -1.27% per annum per 1 grade increase, P < 0.05 for all comparisons), and risk of knee replacement over 5 years (odds ratio (OR) = 1.73 per 1 grade increase, P = 0.001).
Knee cartilage defects in older adults are common but less likely to regress than in younger life. They independently predict cartilage volume loss and risk of knee replacement, suggesting they are potential targets for intervention.
描述膝关节软骨缺损的自然史，以及在一项对老年人的纵向研究中，它们与软骨体积丧失和膝关节置换风险的关系。
395 名随机选择的老年人（平均年龄 62.7 岁）在基线时和大约 2.9 年后对其右膝关节进行磁共振成像，以确定软骨缺损等级（0-4）、软骨体积、内侧和外侧胫骨大小以及骨髓病变（BML）的存在。身高、体重、体重指数（BMI）和放射学骨关节炎通过标准方案进行测量。
在基线时，较高等级的软骨缺损（等级≥2）与年龄、BMI、外侧胫骨大小、BML 和放射学骨关节炎显著相关。在 2.9 年期间，所有节段的平均缺损评分均有统计学显著增加；然而，大多数缺损保持稳定，缺损的消退很少见。与 2.9 年期间缺损评分增加相关的基线因素包括放射学骨关节炎、胫骨大小、BMI 和女性。在多变量分析中，基线软骨缺损等级预测了内侧胫骨、外侧胫骨和髌骨在 2.9 年内的软骨体积丧失（每增加 1 个等级，每年损失 -1.78%至-1.27%，所有比较均 P<0.05），以及 5 年内膝关节置换的风险（每增加 1 个等级，比值比（OR）为 1.73，P=0.001）。
老年人膝关节软骨缺损很常见，但比年轻时期更不可能消退。它们独立预测软骨体积丧失和膝关节置换的风险，表明它们是潜在的干预目标。
