Tribology Laboratory, School of Civil and Mechanical Engineering, Curtin University, Australia.
Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
J Orthop Res. 2020 Aug;38(8):1819-1825. doi: 10.1002/jor.24593. Epub 2020 Jan 28.
Arthroscopic partial meniscectomy (APM) may lead to changes in underlying trabecular bone (TB) structure potentially promoting the development of knee joint osteoarthritis. Our aim was to investigate if there are early changes occurring in tibial subchondral TB texture in the leg undergoing medial APM compared with the unoperated non-injured contra-lateral leg. The bone texture was measured as the medial-to-lateral ratio of fractal dimensions (FD) calculated for regions selected on weight-bearing anteroposterior tibiofemoral x-rays. Twenty-one subjects before and 12 months after APM were included from 374 patients scheduled for unilateral medial APM. The medial-to-lateral ratio was calculated for horizontal, vertical, and roughest FDs respectively. Higher FD means higher bone roughness. Each FD was calculated over a range of scales using a variance orientation transform method. Mean values of medial-to-lateral horizontal FD calculated for APM knees at follow-up were higher than those at baseline. For unoperated knees the values were lower. The difference in the horizontal FD change from baseline to follow-up between APM and contra-lateral legs was 0.028 (95% CI, 0.004-0.052). The bone roughness changes may reflect the increase in peak knee adduction moment (KAM) and KAM impulse during walking reported for the same cohort in a previous study. They may also reflect early signs of osteoarthritis development and thus, we speculate that individuals with increased bone texture roughness ratio after APM might be at higher risk of knee osteoarthritis development.
关节镜下半月板部分切除术（APM）可能导致潜在的小梁骨（TB）结构发生变化，从而促进膝关节骨关节炎的发展。我们的目的是研究与未手术的对侧未受伤的腿相比，内侧 APM 手术腿的胫骨软骨下 TB 纹理是否会发生早期变化。骨纹理通过计算负重前后位胫股矢状面 X 射线选定区域的分形维数（FD）的内外比来测量。从 374 例预定接受内侧 APM 的单侧患者中，纳入了 21 例患者在 APM 术前和术后 12 个月的资料。分别计算了水平、垂直和最粗糙 FD 的内外比。较高的 FD 表示较高的骨粗糙度。每个 FD 使用方差取向变换方法在一系列尺度上进行计算。随访时 APM 膝关节内侧到外侧水平 FD 的平均值高于基线时的值。未手术膝关节的数值较低。APM 和对侧膝关节从基线到随访的水平 FD 变化差异为 0.028（95%CI，0.004-0.052）。与之前同一队列报告的行走时峰值膝内收力矩（KAM）和 KAM 冲量增加相比，骨粗糙度的变化可能反映了这一点。它们也可能反映了骨关节炎发展的早期迹象，因此，我们推测 APM 后骨纹理粗糙度比增加的个体可能有更高的膝关节骨关节炎发展风险。
