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关节镜下内侧半月板部分切除术后软骨的磁共振成像弛豫时间显示局部退变。

Cartilage MRI relaxation times after arthroscopic partial medial meniscectomy reveal localized degeneration.

作者信息

Souza Richard B, Wu Samuel J, Morse Lee Jae, Subburaj K, Allen Christina R, Feeley Brian T

机构信息

Department of Physical Therapy and Rehabilitation Science, University of California San Francisco, 185 Berry Street, Suite 350, San Francisco, CA, 94107, USA,

出版信息

Knee Surg Sports Traumatol Arthrosc. 2015 Jan;23(1):188-97. doi: 10.1007/s00167-014-2997-2. Epub 2014 May 4.

Abstract

PURPOSE

Little is known about the early changes in cartilage composition and tibiofemoral kinematics following partial meniscectomy. The purpose of this study was to determine the effects of partial meniscectomy on cartilage compositional properties using T1ρ and T2 relaxation time mapping and to assess changes in tibiofemoral kinematics. It is hypothesize that abnormal tibiofemoral kinematics and relaxation time elevation (a reflection of changes in cartilage biochemical composition) in the weight-bearing regions of the knees following meniscectomy will be observed.

METHODS

Nine patients (7 males and 2 females; mean age, 48.6 ± 10.8 years; BMI = 27.3 ± 3.8 kg/m(2)) with tears of the posterior horn of the medial meniscus underwent arthroscopic partial meniscectomy. Pre-surgical and 6 months post-surgical MRIs were obtained in all subjects to evaluate cartilage relaxation times and tibiofemoral kinematics. Paired t tests were performed to determine significant changes in cartilage relaxation times from baseline.

RESULTS

T1ρ relaxation time in the region of the medial femoral condyle directly adjacent to the resection showed an increase of 7.4% at 6 months (p = 0.02). T2 relaxation times in both the medial and lateral tibial plateaus showed significant elevation at 6 months. Consistent kinematic trends were not found in post-meniscectomized knees.

CONCLUSIONS

These results suggest that arthroscopic partial meniscectomy affects the biochemical composition of articular cartilage in the knee in as early as 6 months. The largest responses were observed in the weight-bearing regions and the cartilage immediately adjacent to the resection. This suggests that the loading environment has been altered enough to result in cartilage compositional changes in a very brief period of time following meniscectomy.

LEVEL OF EVIDENCE

IV.

摘要

目的

关于半月板部分切除术后软骨成分和胫股关节运动学的早期变化,人们了解甚少。本研究的目的是使用T1ρ和T2弛豫时间映射来确定半月板部分切除术对软骨成分特性的影响,并评估胫股关节运动学的变化。假设半月板切除术后膝关节负重区域会出现异常的胫股关节运动学和弛豫时间升高(反映软骨生化成分的变化)。

方法

9例内侧半月板后角撕裂患者(7例男性,2例女性;平均年龄48.6±10.8岁;体重指数=27.3±3.8kg/m²)接受了关节镜下半月板部分切除术。所有受试者均在术前和术后6个月进行MRI检查,以评估软骨弛豫时间和胫股关节运动学。采用配对t检验来确定软骨弛豫时间相对于基线的显著变化。

结果

紧邻切除部位的内侧股骨髁区域的T1ρ弛豫时间在术后6个月增加了7.4%(p=0.02)。内侧和外侧胫骨平台的T2弛豫时间在术后6个月均显著升高。半月板切除术后的膝关节未发现一致的运动学趋势。

结论

这些结果表明,关节镜下半月板部分切除术早在6个月时就会影响膝关节软骨的生化成分。在负重区域和紧邻切除部位的软骨中观察到的反应最大。这表明在半月板切除术后的很短时间内,负荷环境发生了足够的改变,从而导致软骨成分发生变化。

证据水平

IV级。

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