Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan.
Department of Social Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan.
Clin Rheumatol. 2017 Nov;36(11):2557-2564. doi: 10.1007/s10067-017-3803-6. Epub 2017 Sep 17.
The objective of this study is to determine whether meniscal extrusion (ME) of the medial meniscus on ultrasonography affects knee osteoarthritis (KOA) progression during 3-year follow-up. Two hundred seventy volunteers (70 men, 200 women; mean age 60.5 years) participated. Weight-bearing radiographs were evaluated. All subjects had medial radiographic KOA (Kellgren-Lawrence grade [KLG], ≥ 2) in at least one knee at baseline (BL). KLG 2 was defined as moderate KOA (MKOA); KLG 3 and 4 were defined as severe KOA (SKOA). Medial and lateral joint space width (MJSW and LJSW) were measured at the minimum width of femoro-tibial compartment. The medial and lateral osteophyte area (MOPA and LOPA) were measured. Rapid joint space narrowing progression (RP) was defined as ≥ 25% loss of JSW from BL. ME was measured at the medial knee joint space on the medial collateral ligament with ultrasonography. The optimal ME cut-off for RP was determined by ROC curve. The relationship between ME and the longitudinal change of radiographic parameters was elucidated by linear and logistic regression analysis. In the 460 OA knees at BL, both MOPA and LOPA increased, while only MJSW narrowed after 3 years. RP occurred in 25 knees among 281 MKOA knees and 42 among 179 SKOA knees. ME was associated with medial joint space narrowing only in the SKOA group, while the ME was associated with MOPA in the MKOA and SKOA groups. The cut-off value to detect RP was 5.5 mm only in the SKOA group. Ultrasonographic evaluation of medial ME was useful to detect radiographic KOA progression.
本研究旨在确定内侧半月板超声下的半月板挤出（ME）是否会影响 3 年随访期间的膝骨关节炎（KOA）进展。270 名志愿者（70 名男性，200 名女性；平均年龄 60.5 岁）参与了这项研究。进行了负重 X 线检查。所有受试者在基线（BL）时至少有一侧膝关节存在内侧放射学 KOA（Kellgren-Lawrence 分级[KLG]，≥2）。KLG 2 定义为中度 KOA（MKOA）；KLG 3 和 4 定义为重度 KOA（SKOA）。在股胫关节间最小宽度处测量内侧和外侧关节间隙宽度（MJSW 和 LJSW）。测量内侧和外侧骨赘面积（MOPA 和 LOPA）。快速关节间隙狭窄进展（RP）定义为 BL 时 JSW 损失≥25%。使用超声在膝关节内侧关节间隙的内侧副韧带处测量 ME。通过 ROC 曲线确定用于 RP 的最佳 ME 截止值。通过线性和逻辑回归分析阐明 ME 与放射学参数纵向变化之间的关系。在 BL 时的 460 个 OA 膝关节中，MOPA 和 LOPA 均增加，而只有 MJSW 在 3 年后变窄。281 个 MKOA 膝关节中有 25 个发生 RP，179 个 SKOA 膝关节中有 42 个发生 RP。ME 仅与 SKOA 组的内侧关节间隙狭窄有关，而 ME 与 MKOA 和 SKOA 组的 MOPA 有关。仅在 SKOA 组中，检测 RP 的截止值为 5.5mm。内侧 ME 的超声评估有助于检测放射学 KOA 进展。
