动态超声揭示了膝骨关节炎患者内侧半月板挤压的特定表现。
Dynamic ultrasound reveals the specific behavior of the medial meniscus extrusion in patients with knee osteoarthritis.
机构信息
Department of Biomechanics, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8553, Japan.
Department of Orthopaedic Surgery, Faculty of Medicine, Kagawa University, Kagawa, Japan.
出版信息
BMC Musculoskelet Disord. 2023 Apr 10;24(1):272. doi: 10.1186/s12891-023-06361-6.
BACKGROUND
In the dynamic condition, knee osteoarthritis (OA) usually presents with pain. In the weight-bearing condition, a medial meniscus extrusion (MME) may cause severe symptoms and pathological progression. However, the correlation between a dynamic MME and pain has not been elucidated. Now, an MME can be evaluated under dynamic conditions and reflect the characteristics of symptomatic knee OA. This study investigated MMEs during walking and their correlation with knee pain.
METHODS
Thirty-two symptomatic patients with knee OA (mean age, 60.5 ± 9.9 years) were enrolled in this study. The medial meniscus was evaluated using ultrasonograms during walking, and in the static supine and unipedal standing positions, as dynamic and static conditions, respectively. The ΔMME (the difference between the maximum and minimum MMEs) was obtained in each condition. The intensity of the knee pain during walking was measured by the visual analog scale (VAS).
RESULTS
The ΔMME in the dynamic condition was significantly higher than that in the static condition (P < 0.01). There was a significant correlation between VAS and ΔMME only in the dynamic condition.
CONCLUSIONS
The dynamic evaluation is a valid tool for understanding the mechanisms of knee pain and the behavior of the medial meniscus in symptomatic knee OA.
背景
在动态条件下，膝骨关节炎（OA）通常表现为疼痛。在承重条件下，内侧半月板挤压（MME）可能会导致严重的症状和病理进展。然而，动态 MME 与疼痛之间的相关性尚未阐明。现在，MME 可以在动态条件下进行评估，并反映出有症状的膝 OA 的特征。本研究探讨了行走过程中的 MME 及其与膝关节疼痛的关系。
方法
本研究纳入了 32 例有膝关节 OA 症状的患者（平均年龄 60.5±9.9 岁）。在行走过程中，使用超声评估内侧半月板，并在仰卧位和单足站立位的静态条件下进行评估，分别作为动态和静态条件。在每个条件下获得 ΔMME（最大和最小 MME 之间的差异）。通过视觉模拟量表（VAS）测量行走时膝关节疼痛的强度。
结果
动态条件下的 ΔMME 明显高于静态条件（P<0.01）。仅在动态条件下，VAS 与 ΔMME 之间存在显著相关性。
结论
动态评估是理解膝关节疼痛机制和有症状的膝 OA 中内侧半月板行为的有效工具。
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