Kanak Michał, Pawłuś Natalia, Mostowy Marcin, Piwnik Marcin, Domżalski Marcin, Lesman Jędrzej
Department of Orthopaedics and Traumatology, Veterans' Memorial Teaching Hospital in Lodz, Medical University of Lodz, 90-419 Lodz, Poland.
OrtoTeam Clinic, 90-127 Lodz, Poland.
J Clin Med. 2024 Apr 27;13(9):2578. doi: 10.3390/jcm13092578.
: The pericruciate fat pad (PCFP) in the knee joint is still insufficiently studied despite its potential role in knee pathologies. This is the first reported study which aimed to clarify the characteristics of the PCFP in healthy individuals and contrast them with cases of post-traumatic injuries. : Conducted as a retrospective cross-sectional study ( = 110 knees each) following STROBE guidelines, it employed grayscale ultrasound with echogenicity measurement, compression elastography with elasticity measurement, and Color Doppler for blood flow assessment. : PCFP showed a homogenic and hyperechoic echostructure. The echogenicity of the PCFP was higher than that of the posterior cruciate ligament (PCL) ( < 0.001, z-score = 8.97) and of the medial head of gastrocnemius (MHG) ( = 0.007, z-score = 2.72) in healthy knees, but lower than subcutaneous fat (SCF) ( < 0.001, z-score = -6.52). Post-injury/surgery, PCFP echogenicity surpassed other structures ( < 0.001; z-score for PCL 12.2; for MHG 11.65 and for SCF 12.36) and notably exceeded the control group ( < 0.001, z-score = 8.78). PCFP elasticity was lower than MHG and SCF in both groups, with significantly reduced elasticity in post-traumatic knees (ratio SCF/PCFP 15.52 ± 17.87 in case group vs. 2.26 ± 2.4 in control group; < 0.001; z-score = 9.65). Blood flow was detected in 71% of healthy PCFPs with three main patterns. : The main findings, indicating increased echogenicity and reduced elasticity of PCFP post-trauma, potentially related to fat pad fibrosis, suggest potential applications of echogenicity and elasticity measurements in detecting and monitoring diverse knee pathologies. The description of vascularity variations supplying the PCFP adds additional value to the study by emphasizing the clinically important role of PCFP as a bridge for the middle genicular artery on its way to the inside of the knee joint.
膝关节的十字韧带周围脂肪垫（PCFP）尽管在膝关节病变中可能发挥作用，但目前仍研究不足。这是首次报道的旨在阐明健康个体中PCFP特征并将其与创伤后损伤病例进行对比的研究。
按照STROBE指南进行的一项回顾性横断面研究（每组110个膝关节），采用了具有回声测量功能的灰阶超声、具有弹性测量功能的压缩弹性成像以及用于血流评估的彩色多普勒。
PCFP显示出均匀的高回声结构。在健康膝关节中，PCFP的回声高于后交叉韧带（PCL）（P<0.001，z值=8.97）和腓肠肌内侧头（MHG）（P=0.007，z值=2.72），但低于皮下脂肪（SCF）（P<0.001，z值=-6.52）。损伤/手术后，PCFP的回声超过其他结构（P<0.001；PCL的z值为12.2；MHG的z值为11.65，SCF的z值为12.36），并且显著超过对照组（P<0.001，z值=8.78）。两组中PCFP的弹性均低于MHG和SCF，创伤后膝关节的弹性显著降低（病例组中SCF/PCFP的比值为15.52±17.87，对照组为2.26±2.4；P<0.001；z值=9.65）。71%的健康PCFP检测到血流，有三种主要模式。
主要发现表明创伤后PCFP的回声增加且弹性降低，这可能与脂肪垫纤维化有关，提示回声和弹性测量在检测和监测各种膝关节病变中的潜在应用。对供应PCFP的血管变化的描述通过强调PCFP作为膝中动脉进入膝关节内部途中的桥梁的临床重要作用，为该研究增添了额外价值。
