Okada Kentaro, Yamaguchi Satoshi, Sato Yasunori, Enomoto Takahiro, Ogawa Yuya, Ohtori Seiji, Tahara Masamichi, Sasho Takahisa
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan.
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan; College of Liberal Arts and Sciences, Chiba University, Chiba Japan.
J Orthop Sci. 2019 Jan;24(1):121-127. doi: 10.1016/j.jos.2018.08.003. Epub 2018 Aug 28.
Medial meniscal extrusion (ME) is a biomarker to predict later development of knee osteoarthritis (KOA). On the other hand, we have reported osteophyte formation at the posterior condylar notch of the femur served as a biomarker for the same purpose. The purpose of this study is to compare capacity of the two biomarkers in predicting KOA development.
Two cohort of knees were established utilizing publicly available data from the Osteoarthritis Initiative (OAI). No OA group (NOA) consisted of knees that were grade 0 or 1 on Kellgren and Lawrence grade (K/L) both at baseline and 48 months later, and pre-radiographic-OA group (PROA) consisted of knees that were grade 0 or 1 at baseline but grade ≥2 48 months later. Baseline MR images were evaluated in terms of ME and osteophyte formation at the posterior condylar notch. ME was evaluated both by meniscus subluxation index (MSI) indicating the ratio of the extruded width of the medial meniscus to the width of medial meniscal body and by the medial radial displacement (MRD) indicating actual extruded width. The size of the osteophyte was assessed using a semi-quantitative whole-organ magnetic resonance imaging score (WORMS). The predictive accuracy of KOA was assessed by the area under the receiver operating characteristic curve (AUC) and optimal cutoff was determined for each parameter.
The AUC for MSI was 0.654 (0.561-0.748: 95% CI) and the cutoff value was determined as 17%. That for MRD was 0.677 (0.584-0.770) and the cutoff value was 2.2 mm. The AUC for the WORMS score at the posterior condylar notch was 0.667 (0.579-0.756) and the cutoff value was 2.
Similar predicting capacity of KOA development was found both in ME and osteophyte formation at the posterior condylar notch. Using these simple parameter, mas-screening for KOA development would be possible.
内侧半月板挤压（ME）是预测膝关节骨关节炎（KOA）后期发展的生物标志物。另一方面，我们报告了股骨髁后切迹处骨赘形成可作为相同目的的生物标志物。本研究的目的是比较这两种生物标志物预测KOA发展的能力。
利用骨关节炎倡议（OAI）的公开可用数据建立了两个膝关节队列。非骨关节炎组（NOA）由基线和48个月后Kellgren-Lawrence分级（K/L）均为0级或1级的膝关节组成，放射学前期骨关节炎组（PROA）由基线时为0级或1级但48个月后为≥2级的膝关节组成。对基线磁共振成像（MR）图像进行内侧半月板挤压和髁后切迹处骨赘形成的评估。通过半月板半脱位指数（MSI）（指示内侧半月板挤压宽度与内侧半月板体宽度的比值）和内侧径向位移（MRD）（指示实际挤压宽度）评估内侧半月板挤压。使用半定量全器官磁共振成像评分（WORMS）评估骨赘大小。通过受试者操作特征曲线下面积（AUC）评估KOA的预测准确性，并为每个参数确定最佳截断值。
MSI的AUC为0.654（0.561 - 0.748：95%可信区间），截断值确定为17%。MRD的AUC为0.677（0.584 - 0.770），截断值为2.2毫米。髁后切迹处WORMS评分的AUC为0.667（0.579 - 0.756），截断值为2。
在内侧半月板挤压和髁后切迹处骨赘形成中发现了类似的预测KOA发展的能力。使用这些简单参数，对KOA发展进行大规模筛查将成为可能。
