Department of Rheumatology & Allergy, Xuanwu Hospital, Capital Medical University, Beijing, China.
Clinical Research Centre, Zhujiang Hospital of Southern Medical University, Guangzhou, China.
J Orthop Res. 2022 Aug;40(8):1787-1793. doi: 10.1002/jor.25204. Epub 2021 Nov 2.
The study aimed to determine the associations between the morphological types of proximal tibiofibular joint (PTFJ) and the risk of total knee replacement (TKR) in a cohort of participants with progressive osteoarthritis. A nested case-control design was performed in Osteoarthritis Initiative study. The case knees were those with TKR at 24-60 months follow up (cases), and were 1:1 matched with control knees by age, sex, and Kellgren-Lawrence grade at baseline. The morphological type of each PTFJ was identified according to the coronal and sagittal MR images. Conditional logistic regression models were used to examine the association of the PTFJ types with the risk of TKR at baseline and the time point before TKR (T ). A total of 193 case knees at baseline and 148 case knees at T time point had matched controls between 12 and 60 M. Seven types of the PTFJ were identified and classified into three categories: plane, trochoid, and irregular types. The prevalence of the irregular type was higher in case knees than in controls both at baseline (cases vs. controls, 35.8% vs. 26.9%) and at T time point (cases vs. controls, 33.1% vs. 27.0%). The irregular type of the PTFJ at baseline (odds ratio: 1.62, 95% confidence interval: 1.01-2.59) rather than at T time point was significantly associated with increased odds of TKR. The irregular types of the PTFJ at baseline are associated with increased risk of TKR, suggesting PTFJ may play a role in knee osteoarthritis.
本研究旨在确定胫骨腓骨关节（PTFJ）近端形态类型与进展性骨关节炎患者队列中全膝关节置换（TKR）风险之间的关联。采用骨关节炎倡议研究中的嵌套病例对照设计。病例组为随访 24-60 个月时行 TKR 的膝关节（病例），并按年龄、性别和基线时的 Kellgren-Lawrence 分级与对照组 1:1 匹配。根据冠状位和矢状位 MRI 图像确定每个 PTFJ 的形态类型。使用条件逻辑回归模型检查 PTFJ 类型与基线时和 TKR 前（T）时间点 TKR 风险的关联。基线时有 193 例病例膝关节和 148 例病例膝关节在 T 时间点有 12-60 个月的匹配对照。确定了 7 种 PTFJ 类型，并分为 3 类：平面型、回旋型和不规则型。不规则型在病例膝关节中的患病率高于对照组，无论是在基线时（病例 vs. 对照组，35.8% vs. 26.9%）还是在 T 时间点（病例 vs. 对照组，33.1% vs. 27.0%）。基线时 PTFJ 的不规则类型（比值比：1.62，95%置信区间：1.01-2.59）而非 T 时间点与 TKR 发生的几率增加显著相关。基线时 PTFJ 的不规则类型与 TKR 风险增加相关，表明 PTFJ 可能在膝关节骨关节炎中起作用。
