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老年人群髌下脂肪垫的定性和定量测量:与膝关节疼痛、放射学骨关节炎、运动学和膝关节动力学的关系。

Qualitative and Quantitative Measures in the Infrapatellar Fat Pad in Older Adults: Associations with Knee Pain, Radiographic Osteoarthritis, Kinematics, and Kinetics of the Knee.

机构信息

Shi's Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China; Institute of Traumatology & Orthopedics, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China.

Shanghai University of Traditional Chinese Medicine, Shanghai, China.

出版信息

Acad Radiol. 2024 Aug;31(8):3315-3326. doi: 10.1016/j.acra.2024.02.013. Epub 2024 Feb 27.

DOI:10.1016/j.acra.2024.02.013
PMID:38413312
Abstract

RATIONALE AND OBJECTIVES

The purpose of this study is to delineate cross-sectional associations between qualitative and quantitative measures of the infrapatellar fat pad (IPFP) and knee symptoms, structure, kinematics, and kinetics in older adults.

METHODS

Ninety eligible subjects (90 knees, mean age 54.0 years, 68.9% female) were examined at our center. We used T2-weighted fat-suppressed magnetic resonance imaging (MRI) to evaluate signal intensity alteration, maximum sagittal area, and depth of the IPFP. Symptomatic osteoarthritis (SOA) was a pain subscale score greater than 0 on the Western Ontario McMaster Osteoarthritis Index. A Kellgren-Lawrence grade ≥ 2 identified incident radiographic osteoarthritis (iROA). Three-dimensional gait data were employed to analyze knee joint kinematics and kinetics. Correlation and regression analyzes assessed associations between IPFP measurements and SOA, iROA, kinematics, and kinetics.

RESULTS

There were strong and positive associations between IPFP signal intensity alteration and both SOA and iROA in multivariable regression analyzes [OR (95% CI): 2.849 (1.440 to 5.636), 2.356 (1.236 to 4.492), respectively]. Conversely, a significant negative correlation was observed between IPFP maximum area and flexion angle [B (95%CI): - 1.557 (-2.549 to -0.564)]. Moreover, adjusting for covariates did not reveal any significant correlation between IPFP parameters and other indicators (P > 0.05, respectively).

CONCLUSION

IPFP signal intensity alteration and area were associated with knee clinical symptoms, structural abnormalities, and flexion angle in adults over 40, respectively. These findings suggest that IPFP may be a crucial imaging biomarker in early and middle knee osteoarthritis.

摘要

背景与目的

本研究旨在描述髌下脂肪垫(IPFP)的定性和定量测量指标与老年人膝关节症状、结构、运动学和动力学之间的横断面关联。

方法

本研究共纳入 90 名符合条件的受试者(90 个膝关节,平均年龄 54.0 岁,68.9%为女性)。我们使用 T2 加权脂肪抑制磁共振成像(MRI)评估 IPFP 的信号强度改变、最大矢状面积和深度。膝关节症状性骨关节炎(SOA)的定义为 Western Ontario McMaster Osteoarthritis Index 疼痛亚量表评分大于 0。Kellgren-Lawrence 分级≥2 识别出新发放射学骨关节炎(iROA)。三维步态数据用于分析膝关节运动学和动力学。相关和回归分析评估了 IPFP 测量值与 SOA、iROA、运动学和动力学之间的关联。

结果

在多变量回归分析中,IPFP 信号强度改变与 SOA 和 iROA 均呈强正相关[比值比(95%置信区间):2.849(1.440 至 5.636),2.356(1.236 至 4.492)]。相反,IPFP 最大面积与屈曲角度之间存在显著负相关[B(95%置信区间):-1.557(-2.549 至-0.564)]。此外,调整协变量后,IPFP 参数与其他指标之间没有发现任何显著相关性(P>0.05)。

结论

IPFP 的信号强度改变和面积分别与 40 岁以上成年人的膝关节临床症状、结构异常和屈曲角度相关。这些发现表明,IPFP 可能是早期和中期膝关节骨关节炎的重要影像学生物标志物。

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