Department of Orthopedic Surgery, Akita Hospital, 2-6-12 Takara, Chiryu, Aichi, 472-0056, Japan.
Rheumatol Int. 2019 Apr;39(4):679-687. doi: 10.1007/s00296-019-04247-2. Epub 2019 Jan 28.
This study aimed to identify the parameters related to the area and adipose tissue content of thigh muscles that are associated with radiographic knee osteoarthritis grade. Fifty patients (mean age ± standard deviation, 73.0 ± 4.5 years) were divided into early osteoarthritis (n = 23) and established osteoarthritis (n = 27) groups based on Kellgren-Lawrence classification. The femorotibial angle was measured from anteroposterior radiographs of the lower limbs. Individual thigh muscle and adipose tissue areas were analyzed using axial T1-weighted magnetic resonance imaging. After intergroup comparison, logistic regression analysis was performed to determine independent parameters associated with established osteoarthritis. Moreover, correlation coefficients were assessed between the left-right differences of osteoarthritis grade and parameters. Established osteoarthritis exhibited a significantly greater femorotibial angle and increased adipose tissue content in the subcutaneous, intermuscle, and intramuscle of the adductor, vastus lateralis, vastus intermedius, as well as a lower vastus medialis area, in comparison to early osteoarthritis. A greater femorotibial angle, increased intermuscular adipose tissue, and a lower vastus medialis area to knee extensor ratio were significantly independently associated with established osteoarthritis (odds ratio 3.2, 1.8, and 2.0, respectively). The left-right differences of femorotibial angle and vastus medialis area were significantly correlated with osteoarthritis grade, whereas adipose tissue content had no significant correlations with osteoarthritis grade. Greater femorotibial angle and lower vastus medialis area were related with higher osteoarthritis grade. Greater intermuscular adipose tissue content was associated with established osteoarthritis; however, in the left-right differences, adipose tissue content was not related with osteoarthritis grade.
本研究旨在确定与放射学膝关节骨关节炎分级相关的大腿肌肉面积和脂肪组织含量的参数。50 名患者（平均年龄±标准差，73.0±4.5 岁）根据 Kellgren-Lawrence 分类分为早期骨关节炎（n=23）和已确立的骨关节炎（n=27）组。下肢前后位 X 线片测量股胫角。使用轴向 T1 加权磁共振成像分析个体大腿肌肉和脂肪组织的面积。在组间比较后，进行逻辑回归分析以确定与已确立的骨关节炎相关的独立参数。此外，还评估了骨关节炎分级的左右差异与参数之间的相关系数。与早期骨关节炎相比，已确立的骨关节炎的股胫角显著更大，皮下、肌肉间和内收肌的脂肪组织含量增加，股外侧肌、股中间肌和股直肌的面积减小。较大的股胫角、增加的肌肉间脂肪组织和股直肌面积与膝关节伸肌的比例降低与已确立的骨关节炎显著独立相关（比值比分别为 3.2、1.8 和 2.0）。股胫角和股直肌面积的左右差异与骨关节炎分级显著相关，而脂肪组织含量与骨关节炎分级无显著相关性。较大的股胫角和较低的股直肌面积与较高的骨关节炎分级相关。较大的肌肉间脂肪组织含量与已确立的骨关节炎相关；然而，在左右差异方面，脂肪组织含量与骨关节炎分级无关。
