Kesikburun Serdar, Köroğlu Özlem, Yaşar Evren, Güzelküçük Ümüt, Yazcoğlu Kamil, Tan Arif Kenan
From the Department of Physical Medicine and Rehabilitation, Gülhane Military Medical Academy, Turkish Armed Forces Rehabilitation Center, Ankara (SK, EY, ÜG, KY, AKT); and Military Hospital of Elazığ, The Clinics of Physical Medicine and Rehabilitation, Elazığ, Turkey (ÖK).
Am J Phys Med Rehabil. 2015 Aug;94(8):602-8. doi: 10.1097/PHM.0000000000000216.
The aim of this study was to assess the femoral articular cartilage thickness of the intact knee in patients with traumatic lower extremity amputation compared with nonimpaired individuals.
A total of 30 male patients with traumatic lower extremity amputation (mean [SD] age, 31.2 [6.3] yrs) and a random sample of 53 age-matched and body mass index-matched male nonimpaired individuals (mean [SD] age, 29.8 [6.3] yrs) participated in the study. Exclusion criteria were age younger than 18 yrs, history of significant knee injury, previous knee surgery, or rheumatic disease. The femoral articular cartilage thickness was measured using ultrasound at the midpoints of the medial condyle, the intercondylar notch, and the lateral condyle. Ultrasonographic cartilage measurement was performed on the intact side of the patients with amputation and on both sides of the nonimpaired individuals.
The femoral articular cartilage thickness of the intact knees of the patients with amputation was significantly decreased at the lateral and medial condyles compared with the nonimpaired individuals (P < 0.05). There was no significant difference in the measurements at the intercondylar notch between the patients with amputation and the nonimpaired individuals (P > 0.05).
There was a premature cartilage loss in the intact limb knee of the patients with traumatic amputation. This result supports the view that patients with traumatic lower extremity amputation are at increased risk for developing knee osteoarthritis in the intact limb.
本研究旨在评估创伤性下肢截肢患者完整膝关节的股骨关节软骨厚度,并与未受损个体进行比较。
共有30例创伤性下肢截肢男性患者(平均[标准差]年龄,31.2[6.3]岁)和53例年龄匹配、体重指数匹配的未受损男性个体(平均[标准差]年龄,29.8[6.3]岁)参与本研究。排除标准为年龄小于18岁、有严重膝关节损伤史、既往膝关节手术史或风湿性疾病史。使用超声在内侧髁、髁间切迹和外侧髁的中点测量股骨关节软骨厚度。对截肢患者的完整侧和未受损个体的双侧进行超声软骨测量。
与未受损个体相比,截肢患者完整膝关节的股骨关节软骨厚度在内侧和外侧髁处显著降低(P<0.05)。截肢患者和未受损个体在髁间切迹处的测量结果无显著差异(P>0.05)。
创伤性截肢患者完整肢体膝关节存在软骨过早丢失。这一结果支持了创伤性下肢截肢患者完整肢体发生膝关节骨关节炎风险增加的观点。