Natural history of knee cartilage defects and factors affecting change
Natural history of knee cartilage defects and factors affecting change
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DOI：
10.1001/archinte.166.6.651
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发表时间：
2006-03-27
影响因子：
--
通讯作者：
Jones, G
中科院分区：
文献类型：
--
作者：
Ding, CH;Cicuttini, FM;Jones, G
背景资料：膝关节软骨缺损可能在早期骨关节炎中起重要作用，但对其自然史知之甚少。方法：膝关节软骨缺损评分在325名受试者中，使用T1加权脂肪饱和磁共振成像测定软骨体积和骨表面积（范围，0-4）（平均年龄，45岁）在基线和2年后。33%的受试者的病情恶化，在2.3年期间，37%的受试者在任何膝关节间室的软骨缺损评分有改善（>= 1分增加）。软骨缺损评分恶化与女性性别显著相关（内侧和外侧胫股间室的比值比[OR]分别为3.09和3.64）和基线因素，包括年龄（胫股内侧室OR为1.05/年），体重指数（胫股外侧室OR为1.08），胫股骨赘（OR，6.22和6.04/等级），胫骨面积（OR，1.24和2.07每平方厘米），和软骨体积（OR，2.91和1.71每毫升的内侧胫股和髌骨室）。软骨缺损评分的改善与这些因素（除性别外）具有相似但相反的相关性，包括体重指数的降低（OR，内侧胫股间室为1.23）。结论：膝关节软骨缺损是可变的，变化与女性性别、年龄和体重指数相关。增加与基线软骨体积、骨大小和骨赘相关，表明这些在软骨缺损的发病机制中的作用。减肥等干预措施可能会改善膝关节软骨缺损。
Background: Knee cartilage defects may play an important role in early osteoarthritis, but little is known about their natural history.Methods: Knee cartilage defect score (range, 0-4), cartilage volume, and bone surface area were determined using T1-weighted fat-saturated magnetic resonance imaging in 325 subjects (mean age, 45 years) at baseline and 2 years later.Results: Thirty-three percent of the subjects had a worsening (>= 1-point increase) and 37% of the subjects had an improvement (>= 1-point decrease) in cartilage defect score in any knee compartment during 2.3 years. A worsening in cartilage defect score was significantly associated with female sex (odds ratio [OR], 3.09 and 3.64 in the medial and lateral tibiofemoral compartments) and baseline factors, including age (OR, 1.05 per year in the medial tibiofemoral compartment), body mass index (OR, 1.08 in the lateral tibiofemoral compartment), tibiofemoral osteophytes (OR, 6.22 and 6.04 per grade), tibial bone area (OR, 1.24 and 2.07 per square centimeter), and cartilage volume (OR, 2.91 and 1.71 per milliliter in the medial tibiofemoral and patellar compartments). An improvement in cartilage defect score had similar but reversed associations with these factors (except for sex), including a decrease in body mass index (OR, 1.23 in the medial tibiofemoral compartment).Conclusions: Knee cartilage defects are variable, and changes are associated with female sex, age, and body mass index. Increases are associated with baseline cartilage volume, bone size, and osteophytes, suggesting a role for these in the pathogenesis of cartilage defects. Interventions such as weight loss may improve knee cartilage defects.