Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan.
Department of Rehabilitation Medicine, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan.
J Orthop Traumatol. 2023 Nov 28;24(1):60. doi: 10.1186/s10195-023-00739-x.
Bone marrow lesion (BML) is an important magnetic resonance finding (MRI) finding that predicts knee osteoarthritis. The purpose of this study was to investigate the influence of proximal tibial morphology on BML, including the spreading root sign (SRS), in women without radiographic knee osteoarthritis (OA). It was hypothesized that varus alignment and a greater posterior tibial slopes (PTS) are associated with BML.
A total of 359 female volunteers without knee OA who were participants in the Iwaki Health Promotion Project in 2017 or 2019 were enrolled. Participants were divided into the non-OA and early knee OA (EKOA) groups based on the Luyten's classification criteria. The presence of pathological cartilage lesions, BMLs, attritions, meniscal lesions and effusions was scored on T2-weighted fat-suppressed magnetic resonance imaging (MRI) according to the Whole-Organ MRI Scoring system. The medial proximal tibial angle (MPTA) and medial and lateral PTS (MPTS and LPTS, respectively) were measured. Regression and receiver operating characteristic (ROC) analyses were performed to reveal the relationship between BMLs and proximal tibial morphological parameters.
Of the 359 participants, 54 (15%) were classified as having EKOA. The prevalence of cartilage lesions, BMLs, attritions, meniscal lesions and effusions was higher in the EKOA group than in the non-OA group. The two groups had no significant difference in the proximal tibial parameters. Regression analysis revealed that age and a smaller MPTA were associated with BML in both groups. Attrition (p = 0.029) and the MPTS (p = 0.025) were positively associated with BML in the EKOA group.
The prevalence of BMLs was higher in women with EKOA and correlated with the varus and greater posterior slopes in those without radiographic knee OA.
Level III, retrospective case-control study.
骨髓病变（BML）是一种重要的磁共振成像（MRI）发现，可预测膝关节骨关节炎。本研究旨在探讨胫骨近端形态对无放射学膝关节骨关节炎（OA）女性 BML 的影响，包括蔓延根征（SRS）。假设内翻畸形和更大的后胫骨倾斜角（PTS）与 BML 相关。
共纳入 2017 年或 2019 年参加磐城健康促进项目的 359 名无膝关节 OA 的女性志愿者。根据 Luyten 分类标准，将受试者分为非 OA 组和早期膝关节 OA（EKOA）组。根据全器官 MRI 评分系统，对 T2 加权脂肪抑制 MRI 上病理性软骨损伤、BML、磨损、半月板损伤和关节积液进行评分。测量内侧胫骨近端角（MPTA）和内侧及外侧 PTS（MPTS 和 LPTS）。进行回归和受试者工作特征（ROC）分析，以揭示 BML 与胫骨近端形态参数之间的关系。
359 名受试者中，54 名（15%）被归类为 EKOA。EKOA 组的软骨损伤、BML、磨损、半月板损伤和关节积液的发生率均高于非 OA 组。两组的胫骨近端参数无显著差异。回归分析显示，年龄和较小的 MPTA 与两组的 BML 相关。在 EKOA 组中，磨损（p=0.029）和 MPTS（p=0.025）与 BML 呈正相关。
EKOA 女性 BML 的发生率较高，与无放射学膝关节 OA 女性的内翻和更大的后倾斜有关。
III 级，回顾性病例对照研究。
