Siriwanarangsun Palanan, Chen Karen C, Finkenstaedt Tim, Bae Won C, Statum Sheronda, Gentili Amilcare, Chung Christine B
Department of Radiology, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Department of Radiology, University of California, San Diego, School of Medicine, San Diego, CA, USA.
Skeletal Radiol. 2019 Jun;48(6):931-937. doi: 10.1007/s00256-018-3093-3. Epub 2018 Oct 24.
To determine if radiographic medial tibiofemoral offset (MTFO) is associated with: (1) magnetic resonance imaging (MRI) pathology of cartilage, meniscus, and ligament; and (2) a distinct pattern of lateral cartilage degeneration on MRI.
Three hundred consecutive adult knee MRIs with anteroposterior (AP) radiographs were retrospectively reviewed, and 145 studies were included. MTFO was defined as a medial extension of the medial femoral condyle beyond the articular surface of the medial tibial plateau on weight-bearing AP radiographs. The patients were then divided into the MTFO (n = 61) or no-offset (n = 84) groups. On MRI data obtained on a 1.5-Tesla system, articular cartilage of the femoral condyle and tibial plateau were graded using a modified Outerbridge classification (36 sub-regions similar to whole-organ MRI Score (WORMS) system). In addition, MR pathology of the ACL, MCL, LCL, medial and lateral menisci, were determined.
Significantly increased (ANOVA p < 0.007) MR grade of the ligaments, menisci, and cartilage in the MTFO group (ranging from 0.3 to 2.5) compared to the control group (0.2 to 1.1). Color maps of the cartilage grades suggested a marked difference in both severity of degeneration and regional variations between the groups. MTFO group exhibited focally increased cartilage grades in the central, non-weight regions of lateral compartment (region p = 0.07 to 0.12, interaction p = 0.05 to 0.1).
MTFO is associated with overall degeneration of the knee and features a distinct lateral cartilage degeneration pattern, which may reflect non-physiologic contact of the cartilage between the lateral tibial eminence and lateral central femoral condyle.
确定影像学上的胫股内侧偏移（MTFO）是否与以下因素相关：（1）软骨、半月板和韧带的磁共振成像（MRI）病理情况；（2）MRI上外侧软骨退变的独特模式。
回顾性分析300例连续的成人膝关节MRI及前后位（AP）X线片，纳入145项研究。MTFO定义为在负重AP X线片上股骨内侧髁向内侧延伸超过胫骨内侧平台关节面。然后将患者分为MTFO组（n = 61）和无偏移组（n = 84）。在1.5特斯拉系统上获取的MRI数据中，使用改良的Outerbridge分类法（36个亚区域，类似于全器官MRI评分（WORMS）系统）对股骨髁和胫骨平台的关节软骨进行分级。此外，确定前交叉韧带（ACL）、内侧副韧带（MCL）、外侧副韧带（LCL）、内侧和外侧半月板的MR病理情况。
与对照组（0.2至1.1）相比，MTFO组韧带、半月板和软骨的MR分级显著增加（方差分析p < 0.007）（范围为0.3至2.5）。软骨分级的彩色图谱表明两组在退变严重程度和区域差异方面均存在明显差异。MTFO组在外侧间室的中央非负重区域软骨分级局部增加（区域p = 0.07至0.12，交互作用p = 0.05至0.1）。
MTFO与膝关节的整体退变相关，并具有独特的外侧软骨退变模式，这可能反映了胫骨外侧髁与股骨外侧中央髁之间软骨的非生理性接触。
