Heinz Tizian, Meller Felix, Luetkens Karsten Sebastian, Anderson Philip Mark, Stratos Ioannis, Horas Konstantin, Rudert Maximilian, Reppenhagen Stephan, Weißenberger Manuel
Department of Orthopaedic Surgery, University of Wuerzburg, Koenig-Ludwig-Haus, Brettreichstr. 11, 97074, Wuerzburg, Germany.
Department of Diagnostic and Interventional Radiology, University Hospital Wuerzburg, Oberduerrbacherstr. 6, 97080, Wuerzburg, Germany.
J Exp Orthop. 2023 Jan 27;10(1):9. doi: 10.1186/s40634-023-00575-2.
PURPOSE: The Area Measurement And Depth Underlying Structures (AMADEUS) classification system has been proposed as a valuable tool for magnetic resonance (MR)-based grading of preoperatively encountered chondral defects of the knee joint. However, the potential relationship of this novel score with clinical data was yet to determine. It was the primary intention of this study to assess the correlative relationship of the AMADEUS with patient reported outcome scores in patients undergoing medial open-wedge high tibial valgus osteotomy (HTO). Furthermore, the arthroscopic ICRS (International Cartilage Repair Society) grade evaluation was tested for correlation with the AMADEUS classification system. METHODS: This retrospective, monocentric study found a total of 70 individuals that were indicated for HTO due to degenerative chondral defects of the medial compartment between 2008 and 2019. A preoperative MR image as well as a pre-osteotomy diagnostic arthroscopy for ICRS grade evaluation was mandatory for all patients. The Knee Osteoarthritis Outcome Score (KOOS) including its five subscale scores (KOOS-ADL, KOOS-QOL, KOOS-Sports, KOOS-Pain, KOOS-Symptoms) was obtained preoperatively and at a mean follow-up of 41.2 ± 26.3 months. Preoperative chondral defects were evaluated using the AMADEUS classification system and the final AMADEUS scores were correlated with the pre- and postoperative KOOS subscale sores. Furthermore, arthroscopic ICRS defect severity was correlated with the AMADEUS classification system. RESULTS: There was a statistically significant correlation between the AMADEUS BME (bone marrow edema) subscore and the KOOS Symptoms subscore at the preoperative visit (r = 0.25, p = 0.04). No statistically significant monotonic association between the AMADEUS total score and the AMADEUS grade with pre- and postoperative KOOS subscale scores were found. Intraoperatively obtained ICRS grade did reveal a moderate correlative relation with the AMADEUS total score and the AMADEUS grade (r = 0.28, p = 0.02). CONCLUSIONS: The novel AMADEUS classification system largely lacks correlative capacity with patient reported outcome measures in patients undergoing HTO. The MR tomographic appearance of bone marrow edema is the only parameter predictive of the clinical outcome at the preoperative visit.
目的：面积测量与深层结构深度（AMADEUS）分类系统已被提议作为一种有价值的工具，用于基于磁共振（MR）对术前遇到的膝关节软骨损伤进行分级。然而，这一新评分与临床数据之间的潜在关系尚未确定。本研究的主要目的是评估AMADEUS评分与接受内侧开放楔形高位胫骨外翻截骨术（HTO）患者的患者报告结局评分之间的相关性。此外，还测试了关节镜下国际软骨修复协会（ICRS）分级评估与AMADEUS分类系统的相关性。 方法：这项回顾性单中心研究共纳入了70例因2008年至2019年间内侧间室退行性软骨损伤而接受HTO手术的患者。所有患者均需进行术前MR图像检查以及术前截骨诊断性关节镜检查以进行ICRS分级评估。在术前以及平均随访41.2±26.3个月时获取膝关节骨关节炎结局评分（KOOS），包括其五个子量表评分（KOOS-ADL、KOOS-QOL、KOOS-运动、KOOS-疼痛、KOOS-症状）。使用AMADEUS分类系统评估术前软骨损伤情况，并将最终的AMADEUS评分与术前和术后KOOS子量表评分进行相关性分析。此外，将关节镜下ICRS损伤严重程度与AMADEUS分类系统进行相关性分析。 结果：术前AMADEUS骨髓水肿（BME）子评分与KOOS症状子评分之间存在统计学显著相关性（r = 0.25，p = 0.04）。未发现AMADEUS总分和AMADEUS分级与术前和术后KOOS子量表评分之间存在统计学显著的单调关联。术中获得的ICRS分级与AMADEUS总分和AMADEUS分级确实显示出中度相关性（r = 0.28，p = 0.02）。 结论：新型AMADEUS分类系统在很大程度上与接受HTO手术患者的患者报告结局指标缺乏相关性。骨髓水肿的MR断层表现是术前唯一可预测临床结局的参数。
Z Orthop Unfall. 2012-6
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2021-6-15
J Bone Joint Surg Am. 2020-12-2
Knee Surg Sports Traumatol Arthrosc. 2021-10
Br Med Bull. 2013-1-20
BMC Musculoskelet Disord. 2012-10-9
Osteoarthritis Cartilage. 2009-5-7
Zotero 插件
