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人骨关节炎和无症状关节软骨的机电特性是退变的敏感和早期检测指标。

Electromechanical properties of human osteoarthritic and asymptomatic articular cartilage are sensitive and early detectors of degeneration.

机构信息

Biomedical Engineering Institute, Polytechnique Montreal, Montreal, QC, Canada; Biomomentum Inc., 970 Michelin St., Suite 200, Laval, QC H7L 5C1, Canada.

Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Finland; Infotech Oulu, University of Oulu, Finland.

出版信息

Osteoarthritis Cartilage. 2018 Mar;26(3):405-413. doi: 10.1016/j.joca.2017.12.002. Epub 2017 Dec 9.

Abstract

OBJECTIVE

To evaluate cross-correlations of ex vivo electromechanical properties with cartilage and subchondral bone plate thickness, as well as their sensitivity and specificity regarding early cartilage degeneration in human tibial plateau.

METHOD

Six pairs of tibial plateaus were assessed ex vivo using an electromechanical probe (Arthro-BST) which measures a quantitative parameter (QP) reflecting articular cartilage compression-induced streaming potentials. Cartilage thickness was then measured with an automated thickness mapping technique using Mach-1 multiaxial mechanical tester. Subsequently, a visual assessment was performed by an experienced orthopedic surgeon using the International Cartilage Repair Society (ICRS) grading system. Each tibial plateau was finally evaluated with μCT scanner to determine the subchondral-bone plate thickness over the entire surface.

RESULTS

Cross-correlations between assessments decreased with increasing degeneration level. Moreover, electromechanical QP and subchondral-bone plate thickness increased strongly with ICRS grade (ρ = 0.86 and ρ = 0.54 respectively), while cartilage thickness slightly increased (ρ = 0.27). Sensitivity and specificity analysis revealed that the electromechanical QP is the most performant to distinguish between different early degeneration stages, followed by subchondral-bone plate thickness and then cartilage thickness. Lastly, effect sizes of cartilage and subchondral-bone properties were established to evaluate whether cartilage or bone showed the most noticeable changes between normal (ICRS 0) and each early degenerative stage. Thus, the effect sizes of cartilage electromechanical QP were almost twice those of the subchondral-bone plate thickness, indicating greater sensitivity of electromechanical measurements to detect early osteoarthritis.

CONCLUSION

The potential of electromechanical properties for the diagnosis of early human cartilage degeneration was highlighted and supported by cartilage thickness and μCT assessments.

摘要

目的

评估离体生物力学特性与软骨和软骨下骨板厚度的相关性,以及它们在评估人类胫骨平台早期软骨退变方面的敏感性和特异性。

方法

使用一种测量反映关节软骨压缩诱导流体力的定量参数(QP)的机电探针(Arthro-BST)对 6 对胫骨平台进行离体评估。然后使用 Mach-1 多轴力学试验机的自动厚度映射技术测量软骨厚度。随后,由一位经验丰富的矫形外科医生使用国际软骨修复协会(ICRS)分级系统进行视觉评估。最后,使用 μCT 扫描仪评估每个胫骨平台,以确定整个表面的软骨下骨板厚度。

结果

评估之间的相关性随着退变程度的增加而降低。此外,机电 QP 和软骨下骨板厚度与 ICRS 分级呈强正相关(ρ分别为 0.86 和 0.54),而软骨厚度仅略有增加(ρ=0.27)。敏感性和特异性分析表明,机电 QP 是区分不同早期退变阶段最有效的方法,其次是软骨下骨板厚度,然后是软骨厚度。最后,建立了软骨和软骨下骨属性的效应量,以评估在正常(ICRS 0)和每个早期退变阶段之间,软骨或骨是否显示出最明显的变化。因此,软骨机电 QP 的效应量几乎是软骨下骨板厚度的两倍,表明机电测量对早期骨关节炎的检测更敏感。

结论

离体生物力学特性在诊断人类早期软骨退变方面的潜力得到了强调,并得到了软骨厚度和 μCT 评估的支持。

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