Ayral X, Dougados M, Listrat V, Bonvarlet J P, Simonnet J, Amor B
Rheumatology Unit, Hôpital Cochin, Paris, France.
J Rheumatol. 1996 Apr;23(4):698-706.
To evaluate arthroscopic findings as a potential measurement of severity and outcome of chondropathy.
110 patients with knee osteoarthritis (OA) were included in a cross sectional study and 41 of them in a one year longitudinal study. The evaluation of OA performed once in the cross sectional study and twice (at entry and after one year) in the longitudinal study, included clinical, radiological and arthroscopic variables evaluating disease activity and severity. Arthroscopy was performed. under local anesthesia in an outpatient procedure using a small arthroscope. Chondropathy was evaluated by the overall assessment of the investigator by visual analog scale and the Société Française d'Arthroscopie (SFA) scoring and grading systems, which represent a composite index taking into account depth, size, and localization of the articular cartilage lesions.
The intrinsic validity of the arthroscopic variables was suggested by highly significant correlation (R2 = 80-85%) between the overall assessment of the investor and the SFA systems. There was also highly significant correlation (p < 0.01) between the arthroscopic and radiological variables. Intraobserver reliability of the arthroscopic quantification of chondropathy was better than interobserver reliability. In the cross sectional study, severity of chondropathy correlated with both age and body mass index. In the longitudinal study there was statistically significant worsening in the severity of chondropathy and statistically significant correlation between the changes in the severity of chondropathy and changes in functional impairment.
We conclude that arthroscopy might be considered a relevant measurement of OA outcome for research purposes.
评估关节镜检查结果作为软骨病严重程度和预后的潜在衡量指标。
110例膝关节骨关节炎（OA）患者纳入横断面研究，其中41例纳入为期一年的纵向研究。横断面研究中对OA进行一次评估，纵向研究中进行两次评估（入组时和一年后），评估内容包括临床、放射学和关节镜检查变量，以评估疾病活动度和严重程度。在门诊局部麻醉下使用小型关节镜进行关节镜检查。通过研究者使用视觉模拟量表进行的总体评估以及法国关节镜学会（SFA）评分和分级系统对软骨病进行评估，该系统是一个综合指数，考虑了关节软骨损伤的深度、大小和位置。
研究者的总体评估与SFA系统之间高度显著相关（R2 = 80 - 85%），提示关节镜检查变量的内在效度。关节镜检查变量与放射学变量之间也存在高度显著相关（p < 0.01）。软骨病关节镜量化的观察者内信度优于观察者间信度。在横断面研究中，软骨病的严重程度与年龄和体重指数均相关。在纵向研究中，软骨病严重程度有统计学意义的恶化，软骨病严重程度变化与功能损害变化之间存在统计学意义的相关性。
我们得出结论，对于研究目的而言，关节镜检查可被视为OA预后的相关衡量指标。
