Department of Rheumatology, Fundación Jiménez Díaz, 28040 Madrid, Spain.
Rheumatology (Oxford). 2013 Aug;52(8):1443-7. doi: 10.1093/rheumatology/ket110. Epub 2013 Apr 16.
Although clinical reports have described medial meniscal subluxation (MMS) in knee OA, few controlled studies have used dynamic US to examine the potential impact of MMS on OA. The aim of this study was to assess MMS in patients with knee OA and in asymptomatic controls by US in different weight-bearing positions.
In a cross-sectional controlled study, MMS was evaluated by US in 33 symptomatic OA knees and in 13 control knees in supine neutral and unipodal weight-bearing positions. The reproducibility of US in this setting was assessed and the US measurements were compared between patients and controls.
MMS was observed more frequently in OA knees than in controls in the unipodal weight-bearing position both before (P = 0.014) and after (P = 0.035) walking 50 m. In both OA and control knees, an increase in MMS was observed in the unipodal weight-bearing positions compared with the supine neutral position, but this increase was greater in OA knees than in controls (P < 0.001).
Our findings confirm clinical observations that the medial meniscus undergoes significant subluxation in knee OA. The degree of subluxation is greater in weight-bearing than in non-weight-bearing positions. Dynamic US is a reproducible method for the assessment of MMS.
尽管临床报告已经描述了膝骨关节炎（OA）中的内侧半月板半脱位（MMS），但很少有对照研究使用动态超声来检查 MMS 对 OA 的潜在影响。本研究旨在通过不同负重位的超声评估膝 OA 患者和无症状对照者的 MMS。
在一项横断面对照研究中，在仰卧中立位和单足负重位评估了 33 例膝关节 OA 患者和 13 例对照膝关节的 MMS。评估了该环境下的超声重复性，并比较了患者与对照组之间的超声测量值。
在单足负重位，OA 膝关节的 MMS 发生率高于对照组，无论在行走 50 米之前（P = 0.014）还是之后（P = 0.035）。在 OA 和对照组膝关节中，与仰卧中立位相比，单足负重位时 MMS 增加，但 OA 膝关节的增加幅度大于对照组（P < 0.001）。
我们的发现证实了临床观察结果，即膝关节 OA 时内侧半月板会发生明显的半脱位。负重位时的半脱位程度大于非负重位。动态超声是评估 MMS 的一种可靠方法。
