Wenger Andrea, Wirth Wolfgang, Hudelmaier Martin, Noebauer-Huhmann Iris, Trattnig Siegfried, Bloecker Katja, Frobell Richard B, Kwoh C Kent, Eckstein Felix, Englund Martin
Paracelsus Medical University, Salzburg, Austria.
Arthritis Rheum. 2013 Jul;65(7):1804-11. doi: 10.1002/art.37947.
To quantitatively evaluate the position, size, and shape of the menisci in subjects with radiographic knee osteoarthritis (OA) compared to subjects without OA, using magnetic resonance imaging (MRI).
We studied the right knees of 39 Osteoarthritis Initiative participants (24 women and 15 men with a mean age of 59.6 ± 8.7 years) with medial compartment radiographic tibiofemoral OA (Kellgren/Lawrence grade of 2 or 3). Subjects were matched individually for age, sex, and height to controls without knee OA and without risk factors for knee OA. The right knees of the controls were used as references. One observer performed manual segmentation of the tibial plateau and the medial and lateral meniscus based on a coronally reconstructed double-echo steady-state sequence with water excitation, focusing on 5 central 3T MRIs.
In OA knees, there was less meniscal coverage of the medial tibial plateau (435 mm(2) versus 515 mm(2) ; P = 0.0004), the medial meniscus body showed more extrusion (2.64 mm versus 0.53 mm; P < 0.0001), and the peripheral margin had a more convex shape, i.e., bulged more (mean 0.61 mm versus 0.27 mm; P < 0.0001). The thickness or volume of the medial meniscus body of OA knees did not differ substantially from reference knees. In contrast, in OA knees the lateral meniscus body had a larger volume (mean 266 mm(3) versus 224 mm(3) ; P = 0.0005) and extruded more (mean 1.16 mm versus -1.01 mm; P < 0.0001), and the external margin bulged more (mean 0.53 mm versus 0.35 mm; P < 0.0001), than in reference knees.
Our findings indicate altered meniscal position and shape (i.e., more bulging) in both compartments in medial compartment knee OA. These changes may be important features of OA pathogenesis and/or disease consequences.
使用磁共振成像(MRI)定量评估膝关节影像学骨关节炎(OA)患者与无OA患者半月板的位置、大小和形状。
我们研究了骨关节炎倡议项目中39名参与者(24名女性和15名男性,平均年龄59.6±8.7岁)的右膝,这些患者患有内侧间室胫股关节影像学OA(Kellgren/Lawrence分级为2级或3级)。根据年龄、性别和身高将受试者与无膝关节OA且无膝关节OA危险因素的对照组进行个体匹配。将对照组的右膝作为参照。一名观察者基于水激发冠状面重建双回波稳态序列,对5例中心3T MRI图像进行手动分割,确定胫骨平台以及内侧和外侧半月板。
在OA膝关节中,内侧胫骨平台的半月板覆盖面积较小(435平方毫米对515平方毫米;P = 0.0004),内侧半月板体部挤出更多(2.64毫米对0.53毫米;P < 0.0001),且外周缘形状更凸,即凸起更多(平均0.61毫米对0.27毫米;P < 0.0001)。OA膝关节内侧半月板体部的厚度或体积与参照膝关节相比无显著差异。相比之下,与参照膝关节相比,OA膝关节外侧半月板体部体积更大(平均266立方毫米对224立方毫米;P = 0.0005),挤出更多(平均1.16毫米对 -1.01毫米;P < 0.0001),且外缘凸起更多(平均0.53毫米对0.35毫米;P < 0.0001)。
我们的研究结果表明,内侧间室膝关节OA患者两个间室的半月板位置和形状均发生改变(即更凸出)。这些变化可能是OA发病机制和/或疾病后果的重要特征。