Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia; Department of Orthopaedics, 4th Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China.
Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China; Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.
Osteoarthritis Cartilage. 2018 Dec;26(12):1675-1682. doi: 10.1016/j.joca.2018.08.011. Epub 2018 Sep 5.
To validate a method to measure the morphological parameters of the proximal tibiofibular joint (PTFJ) in patients with knee osteoarthritis (OA).
408 participants were examined in this cross-sectional subject-based study. We calculated the fibular contacting area of PTFJ (S) and its projection areas onto the horizontal plane (load-bearing area, Sτ), the sagittal plane (lateral stress-bolstering area, Sφ) and the coronal plane (posterior stress-bolstering area, Sυ). Joint space narrowing (JSN) and osteophyte was measured using radiographs. Cartilage defects, bone marrow lesions (BMLs) and cartilage volume were evaluated using magnetic resonance imaging (MRI).
The average PTFJ fibular contacting area was 2.4 cm (SD, ±0.7 cm). Intra-observer and inter-observer reliabilities of measures of PTFJ morphological parameters were excellent (≥0.90). S, Sτ and Sφ were significantly associated with JSN in the medial tibiofemoral compartment (PR: 1.40, 95% CI 1.10-1.78; PR: 1.65, 95% CI 1.25-2.18 and PR: 0.53, 95% CI 0.29-0.97, respectively). There was a significantly positive association between S, Sτ and medial and/or femoral tibial cartilage defects. S, Sτ and Sυ were significantly and positively associated with medial and/or femoral tibial BMLs (PR: 1.36, 95% CI 1.12-1.64; PR: 1.47, 95% CI 1.17-1.83; and PR: 1.39, 95% CI 1.06-1.82, respectively) after adjustment. S and Sτ were significantly and negatively associated with medial tibial cartilage volume.
This novel method to assess the morphological parameters of PTFJ in MRI is reproducible. These parameters are associated with knee radiographic and MRI-based OA-related structural abnormalities, suggesting clinical construct validity. Its predictive validity needs to be examined in future longitudinal studies.
验证一种测量膝骨关节炎（OA）患者胫腓骨关节（PTFJ）形态参数的方法。
本横断面基于个体的研究共纳入 408 名参与者。我们计算了 PTFJ 的腓骨接触面积（S）及其在水平面上的投影面积（承重面积，Sτ）、矢状面上的投影面积（外侧支撑面积，Sφ）和冠状面上的投影面积（后侧支撑面积，Sυ）。使用 X 线片测量关节间隙狭窄（JSN）和骨赘。使用磁共振成像（MRI）评估软骨缺损、骨髓病变（BMLs）和软骨体积。
平均 PTFJ 腓骨接触面积为 2.4cm（SD，±0.7cm）。PTFJ 形态参数的观察者内和观察者间可靠性均极好（≥0.90）。S、Sτ和 Sφ 与内侧胫股关节间隙狭窄显著相关（PR：1.40，95%CI 1.10-1.78；PR：1.65，95%CI 1.25-2.18；PR：0.53，95%CI 0.29-0.97）。S、Sτ 与内侧和/或股骨胫骨软骨缺损显著正相关。S、Sτ 和 Sυ 与内侧和/或股骨胫骨 BMLs 显著正相关（PR：1.36，95%CI 1.12-1.64；PR：1.47，95%CI 1.17-1.83；PR：1.39，95%CI 1.06-1.82），校正后结果仍如此。S 和 Sτ 与内侧胫骨软骨体积显著负相关。
该方法可在 MRI 中评估 PTFJ 的形态参数，重复性好。这些参数与膝关节放射学和基于 MRI 的 OA 相关结构异常相关，提示其具有临床构念效度。其预测效度需要在未来的纵向研究中进行检验。
