Palmieri-Smith Riann M, Wojtys Edward M, Potter Hollis G
School of Kinesiology, University of Michigan, Ann Arbor, Michigan, U.S.A.; Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan, U.S.A..
Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan, U.S.A.
Arthroscopy. 2016 Jul;32(7):1309-18. doi: 10.1016/j.arthro.2015.12.045. Epub 2016 Mar 2.
To determine if magnetic resonance imaging markers of cartilage matrix and morphology and circulating serum biomarkers of inflammation and matrix degradation differ over time in patients with anterior cruciate ligament (ACL) injury and bone marrow edema lesions (BMELs) when compared with matched control subjects.
We performed a case-control study, in which 11 ACL-injured subjects scheduled to undergo reconstruction and 11 matched control subjects were scheduled for testing. Participants were selected for the ACL reconstruction (ACLR) group if they injured their ACL while participating in sports, were aged 14 to 30 years, had 1 or more BMELs, and were scheduled to undergo bone-patellar tendon-bone ACLR. Testing required patients to undergo magnetic resonance imaging for measurement of T2 relaxation times in standardized regions of interest over the medial and lateral tibial plateaus and femoral condyles and have blood drawn for measurement of cartilage oligomeric matrix protein (COMP) and C-reactive protein levels before ligament reconstruction and 1 year after surgery.
ACL patients had prolonged T2 relaxation times, indicative of cartilage matrix degradation, in the superficial central lateral tibial plateau (P = .02) and deep medial tibial plateau when compared with control subjects (P = .0001). Prolonged T2 relaxation times were also noted over the lateral femoral condyle at baseline for ACL patients compared with control subjects (P = .001), but the differences resolved by 1 year (P = .98). Circulating serum COMP levels were greater in ACL patients (233.23 ± 88.26 ng/mL) compared with control subjects (169.05 ± 64.53 ng/mL, P = .05).
T2 mapping showed prolonged relaxation times in the lateral compartment of the knee in ACLR patients with lateral BMELs. Furthermore, prolonged T2 relaxation times were apparent in the medial compartment of the knee in ACL-injured patients where bone marrow lesions were not present. Higher serum COMP levels were present in ACL-injured subjects when compared with control subjects.
Level II, prospective case-control study.
确定与匹配的对照受试者相比，前交叉韧带（ACL）损伤和骨髓水肿病变（BMELs）患者的软骨基质和形态的磁共振成像标志物以及炎症和基质降解的循环血清生物标志物是否随时间变化。
我们进行了一项病例对照研究，其中11名计划接受重建的ACL损伤受试者和11名匹配的对照受试者计划进行测试。如果参与者在参加体育活动时损伤了ACL，年龄在14至30岁之间，有1个或更多BMELs，并且计划接受骨-髌腱-骨ACL重建，则被选入ACL重建（ACLR）组。测试要求患者在韧带重建前和手术后1年接受磁共振成像，以测量胫骨内侧和外侧平台以及股骨髁标准化感兴趣区域的T2弛豫时间，并抽取血液测量软骨寡聚基质蛋白（COMP）和C反应蛋白水平。
与对照受试者相比，ACL患者在胫骨外侧平台浅表中央（P = 0.02）和胫骨内侧平台深部的T2弛豫时间延长，表明软骨基质降解（P = 0.0001）。与对照受试者相比，ACL患者在基线时股骨外侧髁的T2弛豫时间也延长（P = 0.001），但差异在1年后消失（P = 0.98）。与对照受试者（169.05±64.53 ng/mL，P = 0.05）相比，ACL患者的循环血清COMP水平更高（233.23±88.26 ng/mL）。
T2映射显示，患有外侧BMELs的ACLR患者膝关节外侧间隙的弛豫时间延长。此外，在没有骨髓病变的ACL损伤患者中，膝关节内侧间隙的T2弛豫时间明显延长。与对照受试者相比，ACL损伤受试者的血清COMP水平更高。
II级，前瞻性病例对照研究。
