Hitzl Wolfgang, Wirth Wolfgang, Maschek Susanne, Cotofana Sebastian, Nevitt Michael, John Markus R, Ladel Christoph, Eckstein Felix
Paracelsus Medical University, Salzburg, Austria.
Paracelsus Medical University, Salzburg, Austria, and Chondrometrics, Ainring, Germany.
Arthritis Care Res (Hoboken). 2015 Oct;67(10):1481-6. doi: 10.1002/acr.22608.
To explore whether baseline to 12-month followup change in femorotibial cartilage thickness differs between subjects who received a total knee arthroplasty (TKA) between 24 and 60 months from those without TKA (non-TKA).
In this prospective cohort study, 531 right knees from Osteoarthritis Initiative participants with definite radiographic knee osteoarthritis (Kellgren/Lawrence [K/L] grades 2-4) were studied. Segmentation was applied to coronal fast low-angle shot magnetic resonance images, to quantitatively determine cartilage thickness in 16 femorotibial subregions. Unadjusted P values (t-tests) and P values adjusted for age, baseline body mass index (BMI), K/L grade, and sex (generalized estimating equation models) were used to evaluate differences in longitudinal 1-year rates of cartilage thickness between TKAs and non-TKAs, with total knee arthroplasty status as fixed effect.
Of the 531 participants (mean ± SD ages 63 ± 9 years, BMI 30 ± 4.8 kg/m(2)), 40 received a femorotibial TKA within 4 years. At baseline, TKAs had thinner medial and lateral femorotibial cartilage (-15%; P < 0.001) than non-TKAs. Longitudinal cartilage thickness change was significantly greater in TKAs than in non-TKAs in the total femorotibial joint (area under the curve [AUC] 0.64), the lateral compartment (AUC 0.66), both tibiae (AUC ≥ 0.61), and the first 9 (of 16) ordered values of subregion change (AUC 0.64-0.69). Discrimination was stronger for TKAs that occurred at 24 and 36 months (n = 18) than for those at 48 and 60 months (n = 22).
Knees with incident TKA displayed smaller baseline cartilage thickness and greater lateral as well as location-independent ordered value femorotibial cartilage loss than non-TKAs. Discrimination of cartilage loss was greater for TKAs occurring within 2 years after the measurement than for those occurring later.
探讨在24至60个月期间接受全膝关节置换术（TKA）的受试者与未接受TKA（非TKA）的受试者相比，股胫关节软骨厚度从基线到12个月随访时的变化是否存在差异。
在这项前瞻性队列研究中，对来自骨关节炎倡议参与者的531个右膝进行了研究，这些参与者有明确的膝关节影像学骨关节炎（凯尔格伦/劳伦斯[K/L]分级为2-4级）。对冠状位快速低角度激发磁共振图像进行分割，以定量确定16个股胫亚区域的软骨厚度。未调整的P值（t检验）以及针对年龄、基线体重指数（BMI）、K/L分级和性别调整后的P值（广义估计方程模型）用于评估TKA组和非TKA组之间软骨厚度纵向1年变化率的差异，将全膝关节置换术状态作为固定效应。
在531名参与者（平均年龄±标准差为63±9岁，BMI为30±4.8kg/m²）中，40人在4年内接受了股胫关节TKA。在基线时，TKA组的内侧和外侧股胫关节软骨比非TKA组更薄（-15%；P<0.001）。在整个股胫关节（曲线下面积[AUC]为0.64）、外侧间室（AUC为0.66）、双侧胫骨（AUC≥0.61）以及16个亚区域变化的前9个有序值（AUC为0.64-0.69）中，TKA组的软骨厚度纵向变化显著大于非TKA组。对于在24个月和36个月时进行的TKA（n=18），其辨别力强于在48个月和60个月时进行的TKA（n=22）。
与非TKA组相比，发生TKA的膝关节显示出更小的基线软骨厚度以及更大的外侧和与位置无关的有序值股胫关节软骨损失。对于测量后2年内发生的TKA，软骨损失的辨别力大于之后发生的TKA。
