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非创伤性和创伤性膝骨关节炎患者的对线与软骨厚度的关系。

Relationship between alignment and cartilage thickness in patients with non-traumatic and post-traumatic knee osteoarthritis.

机构信息

Centre for Interdisciplinary Research in Rehabilitation, Constance Lethbridge Rehabilitation Centre, PERFORM Centre, and School of Physical and Occupational Therapy, McGill University, Montreal, Canada.

Medical Imaging, ArthroLab Inc., Montreal, Canada.

出版信息

Osteoarthritis Cartilage. 2019 Apr;27(4):630-637. doi: 10.1016/j.joca.2019.01.002. Epub 2019 Jan 14.

Abstract

OBJECTIVE

To compare cartilage thickness between patients with non-traumatic and post-traumatic knee osteoarthritis (OA) and healthy controls and to determine if disease severity and alignment impact these differences.

DESIGN

Participants with non-traumatic (n = 22) and post-traumatic (n = 19) knee OA, and healthy controls (n = 22) were recruited for this cross-sectional study. Participants underwent 3T magnetic resonance imaging (T1-weighted, 3D sagittal gradient echo sequence) and cartilage thickness was determined in four regions: medial and lateral condyle, and medial and lateral plateau. Lower extremity alignment (mechanical axis angle) and disease severity (Kellgren-Lawrence scores) were measured from full length radiographs. Statistical analysis included one-way analysis of variance (ANOVA) and modified Bonferroni test adjusting for multiple pairwise comparisons. Linear regression analyses examined the relationship between cartilage thickness and knee OA group after controlling for disease severity, meniscal status, and alignment.

RESULTS

In participants with predominantly medial compartment knee OA, compared to healthy controls, those with non-traumatic knee OA had diminished cartilage thickness in the medial plateau (p = 0.035) and those with post-traumatic knee OA had greater cartilage thickness in the lateral condyle (p = 0.044). In the lateral condyle, data revealed that alignment accounted for the variance in cartilage thickness (p = 0.035), in which a stronger relationship was found in the non-traumatic (r = -0.61) than the post-traumatic (r = -0.12) OA group.

CONCLUSIONS

Emerging data demonstrated that participants with non-traumatic knee OA have a stronger relationship between alignment and cartilage thickness than those with post-traumatic knee OA. This indicates that factors involved in knee OA initiation and progression may differ between these OA subtypes.

摘要

目的

比较非创伤性和创伤性膝骨关节炎(OA)患者与健康对照者的软骨厚度,并确定疾病严重程度和对线是否影响这些差异。

设计

这项横断面研究招募了非创伤性(n=22)和创伤性(n=19)膝 OA 以及健康对照者(n=22)。所有参与者均接受了 3T 磁共振成像(T1 加权,3D 矢状梯度回波序列)检查,并在四个部位测量了软骨厚度:内侧和外侧髁,以及内侧和外侧平台。下肢对线(机械轴角度)和疾病严重程度(Kellgren-Lawrence 评分)通过全长 X 线片测量。统计分析包括单因素方差分析(ANOVA)和调整多重配对比较的修正 Bonferroni 检验。线性回归分析在控制疾病严重程度、半月板状态和对线的情况下,检查了软骨厚度与膝 OA 组之间的关系。

结果

在主要为内侧间室膝 OA 的参与者中,与健康对照组相比,非创伤性膝 OA 患者的内侧平台软骨厚度降低(p=0.035),创伤性膝 OA 患者的外侧髁软骨厚度增加(p=0.044)。在外侧髁,数据显示对线解释了软骨厚度的差异(p=0.035),其中非创伤性 OA 组(r=-0.61)的关系强于创伤性 OA 组(r=-0.12)。

结论

新出现的数据表明,与创伤性膝 OA 患者相比,非创伤性膝 OA 患者的对线与软骨厚度之间的关系更强。这表明,这些 OA 亚型在 OA 起始和进展中涉及的因素可能不同。

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