Kawahara Tsuneo, Sasho Takahisa, Katsuragi Joe, Ohnishi Takashi, Haneishi Hideaki
Graduate School of Engineering, Chiba University, 1-33 Yayoi-cho, Inage-ku, Chiba, 263-8522, Japan.
Medical Corporation Jinseikai, Togane, Japan.
J Orthop Surg Res. 2017 Jun 26;12(1):97. doi: 10.1186/s13018-017-0595-y.
The aims of this study were to reveal the characteristics of the meniscal shape at each knee osteoarthritis (OA) severity level and to predict trends or patterns of the meniscal shape change as associated with knee OA progression.
Fifty-one patients diagnosed with knee OA based on X-ray and magnetic resonance (MR) images were evaluated. They were divided into three groups based on the Kellgren-Lawrence (KL) grade: normal group (KL grade of 0 or 1), mild group (KL grade of 2 or 3), and severe group (KL grade of 4). We measured the patients' meniscal size and meniscal extrusion using MR images. In addition, semiquantitative measurement was performed using MR images to determine the arthritic status of the corresponding compartment using a whole-organ magnetic resonance imaging score (WORMS).
The longitudinal diameter and posterior wedge angle of the medial meniscus were significantly larger, and the posterior wedge width of the medial meniscus was significantly smaller in the severe group than in the normal group. The WORMS scores for cartilage and osteophytes in the medial region were significantly different among the groups. The WORMS score of each region was strongly correlated with the longitudinal diameter. The WORMS scores of the lateral region were lower than those of the medial region.
Our observation of the shape change of the medial meniscus in the posterior region was roughly consistent with that in many previous studies of meniscal degeneration. On the other hand, we saw that the most relevant relation between the progression of the knee OA and the deformation of the meniscus was in the longitudinal direction.
本研究的目的是揭示各膝关节骨关节炎（OA）严重程度水平下半月板形状的特征，并预测与膝关节OA进展相关的半月板形状变化趋势或模式。
对51例根据X线和磁共振（MR）图像诊断为膝关节OA的患者进行评估。根据Kellgren-Lawrence（KL）分级将他们分为三组：正常组（KL分级为0或1）、轻度组（KL分级为2或3）和重度组（KL分级为4）。我们使用MR图像测量患者的半月板大小和半月板挤出情况。此外，使用MR图像进行半定量测量，以使用全器官磁共振成像评分（WORMS）确定相应关节腔的关节炎状态。
重度组内侧半月板的纵向直径和后楔角明显更大，内侧半月板的后楔宽度明显小于正常组。内侧区域软骨和骨赘的WORMS评分在各组之间有显著差异。每个区域的WORMS评分与纵向直径密切相关。外侧区域的WORMS评分低于内侧区域。
我们对内侧半月板后部区域形状变化的观察与之前许多半月板退变研究的结果大致一致。另一方面，我们发现膝关节OA进展与半月板变形之间最相关的关系是在纵向方向上。
