From the Russell H. Morgan Department of Radiology and Radiological Science (R.M.K., N.H.N., S.D.) and Department of Orthopaedic Surgery (B.A.Z.), Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 5165, Baltimore, Md 21287; Department of Radiology, Zuyderland Medical Center, Heerlen, the Netherlands (R.M.K.); Department of Radiology, Boston University School of Medicine, Boston, Mass (F.W.R., A.G.); Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany (F.W.K.); and Department of Rheumatology, Royal North Shore Hospital and Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Sydney, Australia (D.J.H.).
Radiology. 2018 Jun;287(3):912-921. doi: 10.1148/radiol.2018171565. Epub 2018 Feb 21.
Purpose To determine whether anterior cruciate ligament (ACL) mucoid degeneration in participants with or at risk for osteoarthritis is associated with longitudinal risk of radiographic progression of medial tibiofemoral compartment joint space loss (JSL). Materials and Methods Baseline demographic, clinical, radiographic, and Magnetic Resonance (MR) Imaging Osteoarthritis Knee Score (MOAKS) data were evaluated in 600 participants from the Osteoarthritis Initiative database. Two blinded musculoskeletal radiologists independently evaluated baseline MR images for ACL mucoid degeneration. Multiple logistic regression was used to investigate the association between ACL mucoid degeneration at MR imaging and JSL progression at radiography, defined as a minimum joint space width decrease greater than 0.7 mm (48 months; cutoff according to mean and standard deviation of 1-year minimum joint space width changes in 90 knees of reference group). Stratified analysis was performed based on baseline cartilage surface damage. Results Knees with ACL mucoid degeneration showed a greater proportion of JSL progression compared with knees with a normal ACL (64% vs 47%; P = .004). After adjustment for all demographic, clinical, radiographic, and MOAKS variables, ACL mucoid degeneration was not statistically significantly associated with JSL progression in the entire cohort (adjusted odds ratio, 1.66; 95% confidence interval: 1.00, 2.77; P = .051). In subgroup analysis, ACL mucoid degeneration was statistically significantly associated with JSL progression in participants with less baseline cartilage surface damage (maximum cartilage surface loss of ≤75% in all subregions [P = .015] and ≤4 of involved subregions with cartilage surface loss [P = .028]). Conclusion ACL mucoid degeneration in participants with or at risk for osteoarthritis is associated with progression of medial tibiofemoral compartment JSL in knees with less baseline cartilage surface area damage. RSNA, 2018 Online supplemental material is available for this article.
目的 旨在确定患有或有骨关节炎风险的参与者的前交叉韧带(ACL)黏液样变性是否与内侧胫骨股骨间室关节间隙损失(JSL)的放射学进展的纵向风险相关。
材料与方法 对来自 Osteoarthritis Initiative 数据库的 600 名参与者的基线人口统计学、临床、放射学和磁共振成像(MRI)骨关节炎膝关节评分(MOAKS)数据进行了评估。两位盲法肌肉骨骼放射科医生独立评估了基线 MRI 图像的 ACL 黏液样变性。多变量逻辑回归用于研究 MRI 成像中 ACL 黏液样变性与放射学 JSL 进展之间的关联,定义为最小关节间隙宽度减少大于 0.7mm(48 个月;根据参考组 90 个膝关节 1 年最小关节间隙宽度变化的平均值和标准差确定的截止值)。根据基线软骨表面损伤进行分层分析。
结果 与 ACL 正常的膝关节相比,具有 ACL 黏液样变性的膝关节显示出更大比例的 JSL 进展(64%比 47%;P=.004)。在调整所有人口统计学、临床、放射学和 MOAKS 变量后,ACL 黏液样变性在整个队列中与 JSL 进展无统计学显著相关性(调整后的优势比,1.66;95%置信区间:1.00,2.77;P=.051)。在亚组分析中,在基线软骨表面损伤较小的参与者中,ACL 黏液样变性与 JSL 进展具有统计学显著相关性(所有亚区的最大软骨表面丢失≤75%[P=.015]和软骨表面丢失涉及的 4 个或更多亚区[P=.028])。
结论 患有或有骨关节炎风险的参与者的 ACL 黏液样变性与基线软骨表面积较小的膝关节内侧胫骨股骨间室 JSL 进展相关。RSNA,2018 在线补充材料可用于本文。