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踝关节骨关节炎中软骨下骨板厚度与软骨退变的相关性

Correlation between subchondral bone plate thickness and cartilage degeneration in osteoarthritis of the ankle.

作者信息

Nakasa Tomoyuki, Adachi Nobuo, Kato Tomohiro, Ochi Mitsuo

机构信息

Department of Orthopaedic Surgery, Integrated Health & Sciences, Institute of Biomedical & Health Science, Hiroshima University, Hiroshima, Japan

Department of Orthopaedic Surgery, Integrated Health & Sciences, Institute of Biomedical & Health Science, Hiroshima University, Hiroshima, Japan.

出版信息

Foot Ankle Int. 2014 Dec;35(12):1341-9. doi: 10.1177/1071100714548061. Epub 2014 Aug 18.

Abstract

BACKGROUND

Osteoarthritis (OA) is characterized not only by cartilage degeneration, but also subchondral bone changes. The subchondral bone plate (SBP) plays an important role in cartilage metabolism, and elucidation of the relationship between the SBP and cartilage degeneration would be helpful to determine the most appropriate treatment strategy for ankle OA. The purpose of this study was to evaluate the SBP and to compare it with cartilage degeneration with arthroscopic findings.

METHODS

Computed tomography (CT) was used to compare the thickness of the SBP of 11 ankle OA patients with that of 11 non-ankle OA patients in 9 areas of the talar dome. The French Society of Arthroscopy (SFA) grading system was used to analyze the relationship between findings on the thickness of SBP and on articular cartilage degeneration in ankle OA.

RESULTS

The SBP in ankle OA was significantly thicker than that of the non-OA ankle. The more severe the articular cartilage degeneration, the thicker the SBP became. The SBP on the sclerotic trabecular bone was significantly thicker than that on decreased trabecular bone. The SFA grade for sclerotic subchondral bone was significantly higher than that for decreased trabecular bone.

CONCLUSION

This study shows that the thickness of SBP and the findings of subchondral bone such as decreased trabecular bone and sclerosis in CT are related to the cartilage degeneration of ankle OA, although a small number of patients were analyzed.

LEVEL OF EVIDENCE

Level III, comparative series.

摘要

背景

骨关节炎(OA)不仅以软骨退变为特征,还伴有软骨下骨改变。软骨下骨板(SBP)在软骨代谢中起重要作用,阐明SBP与软骨退变之间的关系将有助于确定踝关节OA最合适的治疗策略。本研究的目的是评估SBP,并通过关节镜检查结果将其与软骨退变进行比较。

方法

采用计算机断层扫描(CT)比较11例踝关节OA患者和11例非踝关节OA患者距骨穹窿9个区域的SBP厚度。使用法国关节镜学会(SFA)分级系统分析踝关节OA中SBP厚度与关节软骨退变结果之间的关系。

结果

踝关节OA患者的SBP明显厚于非OA踝关节。关节软骨退变越严重,SBP越厚。硬化性小梁骨上的SBP明显厚于小梁骨减少处的SBP。硬化软骨下骨的SFA分级明显高于小梁骨减少处的分级。

结论

本研究表明,尽管分析的患者数量较少,但SBP厚度以及CT中软骨下骨如小梁骨减少和硬化的表现与踝关节OA的软骨退变有关。

证据水平

III级,比较系列研究。

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