Department of Orthopedics, Second Affiliated Hospital of Nanchang University, Nanchang, 330006, China.
Sci Rep. 2024 May 29;14(1):12335. doi: 10.1038/s41598-024-63291-6.
Meniscus pathologies (damage, extrusion) and synovitis are associated with knee osteoarthritis (KOA); however, whether synovitis mediates the relationship between meniscus pathologies and KOA radiographic progression remains unclear. We conducted an observational study in the Osteoarthritis Initiative (OAI) cohort, with a 48-month follow-up. Meniscus pathology and synovitis were measured by MRI osteoarthritis knee score (MOAKS) at baseline and 24 months, and a comprehensive synovitis score was calculated using effusion and Hoffa synovitis scores. The knee osteoarthritis radiographic progression was considered that Kellgren-Lawrence (KL) grade and joint space narrowing (JSN) grade at 48 months were increased compared to those at baseline. This study included a total of 589 participants, with KL grades mainly being KL1 (26.5%), KL2 (34.1%), and KL3 (30.2%) at baseline, while JSN grades were mostly 0 at baseline. A logistic regression model was used to analyze the relationship between meniscus pathology, synovitis, and KOA progression. Mediation analysis was used to evaluate the mediation effect of synovitis. The average age of the participants was 61 years old, 62% of which were female. The medial meniscus extrusion was longitudinally correlated with the progression of KL (odds ratio [OR]: 2.271, 95% confidence interval [CI]: 1.412-3.694) and medial JSN (OR: 3.211, 95% CI: 2.040-5.054). Additionally, the longitudinal correlation between medial meniscus damage and progression of KOA (OR: 1.853, 95% CI: 1.177-2.941) and medial JSN (OR: 1.655, 95% CI: 1.053-2.602) was significant. Synovitis was found to mediate the relationship between medial meniscus extrusion and KL and medial JSN progression at baseline (β: 0.029, 95% CI: 0.010-0.053; β: 0.022, 95% CI: 0.005-0.046) and beyond 24 months (β: 0.039, 95% CI: 0.016-0.068; β: 0.047, 95% CI: 0.020-0.078). However, we did not find evidence of synovitis mediating the relationship between meniscal damage and KOA progression. Synovitis mediates the relationship between medial meniscus extrusion (rather than meniscus damage) and KOA progression.
半月板病变（损伤、挤出）和滑膜炎与膝骨关节炎（KOA）有关；然而，滑膜炎是否介导半月板病变与 KOA 放射学进展之间的关系尚不清楚。我们在骨关节炎倡议（OAI）队列中进行了一项观察性研究，随访时间为 48 个月。基线和 24 个月时通过 MRI 骨关节炎膝关节评分（MOAKS）测量半月板病变和滑膜炎，使用积液和 Hoffa 滑膜炎评分计算综合滑膜炎评分。KOA 放射学进展被认为是 48 个月时 Kellgren-Lawrence（KL）分级和关节间隙狭窄（JSN）分级与基线相比增加。这项研究共纳入了 589 名参与者，基线时 KL 分级主要为 KL1（26.5%）、KL2（34.1%）和 KL3（30.2%），而 JSN 分级基线时主要为 0。使用逻辑回归模型分析半月板病变、滑膜炎与 KOA 进展之间的关系。中介分析用于评估滑膜炎的中介效应。参与者的平均年龄为 61 岁，其中 62%为女性。内侧半月板挤出与 KL 的进展呈纵向相关（比值比[OR]：2.271，95%置信区间[CI]：1.412-3.694）和内侧 JSN（OR：3.211，95% CI：2.040-5.054）。此外，内侧半月板损伤与 KOA 进展（OR：1.853，95% CI：1.177-2.941）和内侧 JSN（OR：1.655，95% CI：1.053-2.602）的纵向相关性也具有统计学意义。研究发现，滑膜炎在基线时（β：0.029，95%CI：0.010-0.053；β：0.022，95%CI：0.005-0.046）和 24 个月后（β：0.039，95%CI：0.016-0.068；β：0.047，95%CI：0.020-0.078）介导了内侧半月板挤出与 KL 和内侧 JSN 进展之间的关系。然而，我们没有发现滑膜炎介导半月板损伤与 KOA 进展之间关系的证据。滑膜炎介导了内侧半月板挤出（而不是半月板损伤）与 KOA 进展之间的关系。
