Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia Department of Orthopaedics, 3rd Affiliated Hospital of Southern Medical University, Guangzhou, China.
Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.
Ann Rheum Dis. 2016 Oct;75(10):1783-8. doi: 10.1136/annrheumdis-2015-208360. Epub 2015 Nov 26.
To describe the associations between infrapatellar fat pad (IPFP) signal intensity alteration at baseline and knee symptoms and structural changes in older adults.
A total of 874 subjects (mean 62.1 years, 50.1% female) selected randomly from local community were studied at baseline and 770 were followed up (only 357 had MRI at follow-up) over 2.6 years. T1-weighted or T2-weighted fat suppressed MRI was used to assess IPFP signal intensity alteration (0-3), cartilage volume, cartilage defects and bone marrow lesions (BMLs) at baseline and 2.6 years later. Knee pain was assessed by self-administered Western Ontario and McMaster Osteoarthritis Index questionnaire. Radiographic osteoarthritis (OA) was assessed.
In cross-sectional analyses, IPFP signal intensity alteration was significantly and positively associated with total knee pain as well as knee cartilage defects, BMLs and knee radiographic OA and negatively associated with patellar cartilage volume after adjustment for age, sex, body mass index and/or radiographic OA. Longitudinally, baseline signal intensity alteration within IPFP was significantly and positively associated with increases in knee pain when going upstairs/downstairs as well as increases in tibiofemoral cartilage defects and BMLs, and negatively associated with change in lateral tibial cartilage volume in multivariable analyses.
IPFP signal intensity alteration at baseline was associated with knee structural abnormalities and clinical symptoms cross-sectionally and longitudinally in older adults, suggesting that it may serve as an important imaging biomarker in knee OA.
描述基线时髌下脂肪垫（IPFP）信号强度改变与老年患者膝关节症状和结构变化之间的关系。
本研究共纳入 874 名（平均年龄 62.1 岁，50.1%为女性）随机选择的当地社区居民作为研究对象，在基线时和 2.6 年后进行研究（仅 357 人在随访时进行了 MRI）。使用 T1 加权或 T2 加权脂肪抑制 MRI 评估基线和 2.6 年后 IPFP 信号强度改变（0-3）、软骨体积、软骨缺损和骨髓病变（BML）。采用自我评估的西部安大略省和麦克马斯特骨关节炎指数问卷评估膝关节疼痛。评估放射学骨关节炎（OA）。
在横断面分析中，IPFP 信号强度改变与总膝关节疼痛以及膝关节软骨缺损、BML 和膝关节放射学 OA 显著正相关，与髌软骨体积显著负相关，调整年龄、性别、体重指数和/或放射学 OA 后仍有统计学意义。纵向分析中，基线时 IPFP 内的信号强度改变与上下楼梯时膝关节疼痛的增加、胫股关节软骨缺损和 BML 的增加显著正相关，与外侧胫骨软骨体积的变化显著负相关，在多变量分析中仍有统计学意义。
在老年患者中，基线时 IPFP 信号强度改变与膝关节结构异常和临床症状在横断面和纵向均相关，表明其可能作为膝关节 OA 的一个重要影像学生物标志物。
