Bone marrow lesion is associated with disability for activities of daily living in patients with early stage knee osteoarthritis
Bone marrow lesion is associated with disability for activities of daily living in patients with early stage knee osteoarthritis
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骨髓病变与早期膝骨关节炎患者日常生活活动能力障碍有关
DOI：
10.1007/s00774-018-0950-z
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发表时间：
2018
影响因子：
3.3
通讯作者：
Kaneko Kazuo
中科院分区：
文献类型：
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作者：
Sadatsuki Ryo;Ishijima Muneaki;Kaneko Haruka;Liu Lizu;Futami Ippei;Hada Shinnosuke;Kinoshita Mayuko;Kubota Mitsuaki;Aoki Takako;Takazawa Yuji;Ikeda Hiroshi;Okada Yasunori;Kaneko Kazuo
膝关节骨关节炎（膝OA）会引起疼痛、活动能力丧失和日常生活能力下降（ADL）。尽管对早期膝关节OA的病理生理学已经有所了解，但早期膝关节OA中与ADL残疾相关的结构变化仍不清楚。本研究的目的是检查磁共振成像（MRI）检测到的与早期膝关节OA患者ADL残疾相关的变化。纳入132例首次到我校医院门诊就诊的早期膝关节内侧OA患者（kelgren - lawrence分级≤2级）。同时进行3.0特斯拉膝关节MRI检查。采用全器官磁共振成像评分（WORMS）对oa相关的结构改变进行评分，并通过日本膝关节骨性关节炎量表（JKOM）评估临床表现。采用中位数四分位数回归进行分析。所有患者均观察到软骨病变、软骨下骨磨损和骨赘。骨髓病变（BMLs）和滑膜炎分别见于60%和55%的患者。软骨下囊肿和韧带改变分别见于6%和17%的患者。患者疼痛程度与内侧软骨病变相关（系数2.50,95%可信区间0.61 ~ 4.40,p< 0.01）。ADL患者的残疾与膝关节内侧的bml相关（0.82,0.21-1.02,p= 0.04）。膝关节内侧的bml与早期膝关节内侧OA患者的ADL残疾相关。
AbstractOsteoarthritis of the knee (knee OA) induces pain, loss of mobility and diminished activities of daily living (ADL). Although an understanding of the pathophysiology of early stage knee OA has been developed, the structural changes associated with disability for ADL in early stage knee OA are still unclear. The aim of the present study was to examine magnetic resonance imaging (MRI)-detected changes associated with disability for ADL in patients with early stage knee OA. One hundred and thirty-two patients with early stage medial knee OA (Kellgren–Lawrence grade ≤ 2) who first visited the outpatient clinic at our university hospital were included. They were also examined by 3.0-Tesla knee MRI. The OA-associated structural changes were scored using the Whole-Organ Magnetic Resonance Imaging Score (WORMS), and clinical manifestations were evaluated by the Japanese Knee Osteoarthritis Measure (JKOM). Median quartile regression was used for the analysis. Cartilage lesion, subchondral bone attrition and osteophytes were observed in all patients. Bone marrow lesions (BMLs) and synovitis were observed in 60% and 55% of the patients, respectively. Subchondral cysts and ligament changes were observed in 6% and 17% of the patients, respectively. Pain severity of the patients was associated with medial cartilage lesions (coefficient 2.50, 95% confidence interval 0.61–4.40,p< 0.01). Disability for ADL of the patients was associated with BMLs in the medial side of the knee joint (0.82, 0.21–1.02,p= 0.04). BMLs in the medial side of the knee joint were associated with disability for ADL of patients with early stage medial knee OA.