Tamaki M, Koga Y
Department of Orthopaedic Surgery, Niigata University School of Medicine, Japan.
Nihon Seikeigeka Gakkai Zasshi. 1994 Sep;68(9):737-50.
To clarify the natural history of osteoarthritis of the knee joint, a field study of the knee joint was performed on the inhabitants of Matsudai Town, Niigata Prefecture in 1979 and 1986. The study included the same 979 individuals, involving 820 women and 159 men, aged between 40 and 65 years in 1986 as in 1979. Narrowing of the femoro-tibial joint space was found in 17.7% and 26.1% of the women, and in 5.3% and 12.0% of the men, in 1979 and 1986, respectively. The individuals without osteoarthritic change and those with subchondral sclerosis or osteophytes in the femoro-tibial joint space exhibited less progressive changes in symptoms and radiographic findings. On the other hand, many of those in whom the joint space was more than 50% narrowed compared with the contralateral joint space had persistent pain, suggesting that they were candidates for active treatment. There were about twice as many women as men with symptomatic osteoarthritis of the knee. A comparative study of a group of women with, and a group of women without, radiographic progression in arthritic changes, indicated that the factors correlated with worsening osteoarthritis of the knee included aging, obesity, varus deformity of the knee, severity of inflammation, and flexion contracture of the knee.
为阐明膝关节骨关节炎的自然病史，1979年和1986年对新潟县松代镇居民的膝关节进行了一项实地研究。该研究涵盖了相同的979名个体，其中女性820名，男性159名，1986年时年龄在40至65岁之间，与1979年相同。1979年和1986年，分别有17.7%和26.1%的女性以及5.3%和12.0%的男性出现股胫关节间隙变窄。在股胫关节间隙无骨关节炎改变以及有软骨下硬化或骨赘的个体中，症状和影像学表现的进展变化较小。另一方面，与对侧关节间隙相比关节间隙变窄超过50%的许多人存在持续性疼痛，这表明他们是积极治疗的候选对象。有症状的膝关节骨关节炎女性人数约为男性的两倍。对一组有影像学关节炎进展变化的女性和一组无此变化的女性进行的比较研究表明，与膝关节骨关节炎恶化相关的因素包括衰老、肥胖、膝关节内翻畸形、炎症严重程度以及膝关节屈曲挛缩。
