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特定分期的半月板特征可预测膝关节骨关节炎的进展:一项基于骨关节炎倡议数据的回顾性队列研究。

Stage-specific meniscal features predict progression of osteoarthritis of the knee: a retrospective cohort study using data from the osteoarthritis initiative.

机构信息

Graduate School of Engineering, Chiba University, 1-33 Yayoi-cho, Inage-ku, Chiba, 263-8522, Japan.

Medical Corporation Jinseikai, Chiba, Japan.

出版信息

BMC Musculoskelet Disord. 2019 Jan 22;20(1):33. doi: 10.1186/s12891-019-2413-7.

Abstract

BACKGROUND

In the progression of osteoarthritis (OA) of the knee, a correlation between meniscal posterior segment injuries and medial meniscal extrusion has been reported, but there have been few reports on the relationship with the meniscal shape. The purpose of this study was to clarify the features of the meniscal shape involved in the progression of knee OA.

METHODS

Data were obtained from the Osteoarthritis Initiative (OAI) database. We defined two sets of subjects. One set included 455 knees of subjects whose OA grade on the Kellgren Lawrence (KL) scale progressed in 24 months from baseline and the other set consisted of 455 knees with no progression. The OA progressed subjects were divided to three groups: the "OA change group", KL0 and KL1 knees that progressed to KL2 and KL3; the "mild change group", KL2 knees that progressed to KL3; and the "severe change group", KL2 and KL3 knees that progressed to KL4. The no progression set was divided into three groups whose OA grade remained unchanged. We used magnetic resonance imaging data and manually measured seven items (longitudinal diameter [LD], anterior wedge thickness, anterior wedge width, posterior wedge width, posterior wedge thickness, anterior wedge angle, posterior wedge angle) from the sagittal slice and the extrusion from the coronal slice. These measurements were compared between knees with and without OA progression.

RESULTS

In the "OA change group" and "mild change group", the anterior and posterior wedge widths and the extrusion were significantly larger, but the anterior and the posterior wedge angles were significantly smaller. In the "severe change group," the LD and the extrusion were significantly larger. In each group, there was no uniform tendency for the correlation coefficient of the parameters evaluated.

CONCLUSIONS

Our findings suggested (1) a larger meniscal LD at the baseline predicted progression of knee OA after 24 months and (2) a larger meniscal width and smaller meniscal angle predicted progression of knee OA after 24 months.

摘要

背景

在膝关节骨关节炎(OA)的进展过程中,已经报道了半月板后段损伤与内侧半月板外突之间存在相关性,但关于半月板形状与OA 进展之间的关系的报道较少。本研究旨在阐明与膝关节 OA 进展相关的半月板形状特征。

方法

从 Osteoarthritis Initiative(OAI)数据库中获取数据。我们定义了两组研究对象。一组包括 455 例膝关节,这些膝关节的 OA 分级在基线后 24 个月内按照 Kellgren Lawrence(KL)量表进展;另一组包括 455 例膝关节,OA 无进展。OA 进展的研究对象分为三组:“OA 变化组”,KL0 和 KL1 膝关节进展为 KL2 和 KL3;“轻度变化组”,KL2 膝关节进展为 KL3;“重度变化组”,KL2 和 KL3 膝关节进展为 KL4。无进展组也分为三组,其 OA 分级保持不变。我们使用磁共振成像数据并手动测量了矢状位上的七个项目(纵向直径[LD]、前楔形厚度、前楔形宽度、后楔形宽度、后楔形厚度、前楔形角、后楔形角)和冠状位上的外突。比较了 OA 有进展和无进展的膝关节之间的这些测量值。

结果

在“OA 变化组”和“轻度变化组”中,前、后楔形宽度和外突明显增大,而前、后楔形角明显减小。在“重度变化组”中,LD 和外突明显增大。在每组中,评估参数的相关系数没有统一的趋势。

结论

我们的研究结果表明:(1)基线时较大的半月板 LD 预测 24 个月后膝关节 OA 的进展;(2)较大的半月板宽度和较小的半月板角预测 24 个月后膝关节 OA 的进展。

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