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半月板损伤、半月板症状与膝关节疼痛严重程度之间的关联。

Associations among meniscal damage, meniscal symptoms and knee pain severity.

作者信息

MacFarlane L A, Yang H, Collins J E, Guermazi A, Jones M H, Teeple E, Xu L, Losina E, Katz J N

机构信息

Orthopedic and Arthritis Center for Outcomes Research, Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, MA, USA; Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Boston, MA, USA.

Orthopedic and Arthritis Center for Outcomes Research, Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, MA, USA.

出版信息

Osteoarthritis Cartilage. 2017 Jun;25(6):850-857. doi: 10.1016/j.joca.2016.12.023. Epub 2016 Dec 30.

Abstract

OBJECTIVE

Meniscal tears occur frequently in patients with knee osteoarthritis (OA). The aim of our study was to determine whether meniscal damage identified on magnetic resonance imaging (MRI) is associated with the severity of knee pain or the frequency of meniscal symptoms in patients with knee OA.

METHODS

We performed a cross-sectional study using data from the Meniscal Tear in Osteoarthritis Research (MeTeOR) trial. We characterized meniscal damage hierarchically as: root tear; maceration; long and short complex or horizontal tears; and simple tears. Subjects completed the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Pain Scale and a survey of frequency of meniscal symptoms. We used multivariable general linear models to assess the relationships between meniscal damage and 1) pain severity; and 2) meniscal symptoms, after adjusting for demographic and radiographic features. In further analysis root tear was considered as a binary variable.

RESULTS

Analysis included 227 knees. Root tears were present in 19%, maceration in 14%, long complex or horizontal tears in 22%, short complex or horizontal tears in 30%, and simple tears in 14%. Root tears were associated with higher WOMAC pain scores. The adjusted mean WOMAC pain score was 45.2 (standard error (SE) 2.7) for those with root tear and 38.7 (SE 1.2) for subjects without root tear (P = 0.03). We did not find statistically significant associations between meniscal morphology and frequency of meniscal symptoms.

CONCLUSION

Root tears were associated with greater pain than meniscal tears or maceration. We did not find a relationship between meniscal damage and meniscal symptoms.

摘要

目的

半月板撕裂在膝关节骨关节炎(OA)患者中很常见。我们研究的目的是确定磁共振成像(MRI)上发现的半月板损伤是否与膝关节OA患者的膝关节疼痛严重程度或半月板症状出现频率相关。

方法

我们使用骨关节炎研究中的半月板撕裂(MeTeOR)试验数据进行了一项横断面研究。我们将半月板损伤分层为:根部撕裂;浸渍;长、短复杂或水平撕裂;以及简单撕裂。受试者完成了西安大略和麦克马斯特大学骨关节炎指数(WOMAC)疼痛量表以及半月板症状出现频率的调查。在调整了人口统计学和影像学特征后,我们使用多变量一般线性模型来评估半月板损伤与1)疼痛严重程度;以及2)半月板症状之间的关系。在进一步分析中,根部撕裂被视为一个二元变量。

结果

分析包括227个膝关节。根部撕裂占19%,浸渍占14%,长复杂或水平撕裂占22%,短复杂或水平撕裂占30%,简单撕裂占14%。根部撕裂与较高的WOMAC疼痛评分相关。有根部撕裂的患者调整后的平均WOMAC疼痛评分为45.2(标准误(SE)2.7),无根部撕裂的受试者为38.7(SE 1.2)(P = 0.03)。我们未发现半月板形态与半月板症状出现频率之间存在统计学上的显著关联。

结论

根部撕裂比半月板撕裂或浸渍与更严重的疼痛相关。我们未发现半月板损伤与半月板症状之间存在关联。

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