Knee cartilage defects: association with early radiographic osteoarthritis, decreased cartilage volume, increased joint surface area and type II collagen breakdown
Knee cartilage defects: association with early radiographic osteoarthritis, decreased cartilage volume, increased joint surface area and type II collagen breakdown
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DOI：
10.1016/j.joca.2004.11.007
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发表时间：
2005-03-01
影响因子：
7
通讯作者：
Jones, G
中科院分区：
文献类型：
--
作者：
Ding, CH;Garnero, P;Jones, G
目的：对成人膝关节软骨缺损与膝关节放射性骨关节炎（ROA）、软骨体积、骨大小和II型胶原蛋白破坏之间的关系提出假设。方法：对372名男女受试者（平均年龄45岁，年龄范围26 ~ 61岁）进行横断面抽样研究。采用t1加权脂肪饱和MRI测定膝关节软骨缺损评分（0-4）、患病率（缺损评分>= 2）、软骨体积和骨表面积。采用酶联免疫吸附法测定尿中II型胶原c端交联末端肽（U-CTX-II）水平。采用标准方案测量身高、体重和ROA。结果：在多因素分析中，膝关节软骨缺损的严重程度和患病率与胫股骨赘（回归系数（β）： + 0.86 ~ + 1.31/单位，比值比（OR）： 2.97 ~ 3.68/单位，除胫股外侧腔室OR外，均P < 0.05）和胫骨骨面积(β: +0.11 ~ +0.25/cm(2)；OR: 1.33-1.58/cm(2)， P均< 0.01)。调整骨赘后，膝关节软骨缺损与关节间隙狭窄的相关性不一致，但与膝关节软骨体积的相关性一致（β值：-0.27 ~ -0.70/ml； OR值：0.16 ~ 0.56/ml，除外侧胫骨软骨部位的OR值P = 0.06外，均P < 0.01）。最后，膝关节软骨缺损严重程度与U-CTX-II显著相关（部分r = + 0.18，总软骨缺损评分P < 0.001）。结论：骨赘和膝关节骨尺寸增大可能与膝关节软骨缺损有因果关系。此外，膝关节软骨缺损可导致软骨破裂增加，导致软骨体积减小，关节间隙变窄，提示膝关节软骨缺损在早期膝关节OA中起重要作用。(c) 2004年国际骨关节炎研究学会。Elsevier Ltd.出版。版权所有。
Objective: To generate hypotheses regarding the associations between knee cartilage defects and knee radiographic osteoarthritis (ROA), cartilage volume, bone size and type II collagen breakdown in adults.Methods: A cross-sectional convenience sample of 372 male and female subjects (mean age 45 years, range 26-61) was studied. Knee cartilage defect score (0-4) and prevalence (a defect score of >= 2), cartilage volume, and bone surface area were determined using T1-weighted fat saturation MRI. Urinary levels of C-terminal crosslinking telopeptide of type II collagen (U-CTX-II) were measured by enzyme-linked immunosorbent assay. Height, weight and ROA were measured by standard protocols.Results: In multivariate analysis, the severity and prevalence of knee cartilage defects were significantly and independently associated with tibiofemoral osteophytes (regression coefficient (beta): + 0.86 to + 1.31/unit, odds ratio (OR): 2.97-3.68/unit, all P < 0.05 with the exception of OR in lateral tibiofemoral compartment) and tibial bone area (beta: +0.11 to +0.25/cm(2); OR: 1.33-1.58/cm(2), all P < 0.01). Knee cartilage defects were inconsistently associated with joint space narrowing after adjustment for osteophytes but consistently with knee cartilage volume (beta: -0.27 to -0.70/ml; OR: 0.16-0.56/ml, all P < 0.01 except for OR at lateral tibial cartilage site P = 0.06). Lastly, knee cartilage defect severity was significantly associated with U-CTX-II (Partial r = + 0.18, P < 0.001 for total cartilage defect score).Conclusion: Osteophytes and increasing knee bone size may be causally related to knee cartilage defects. Furthermore, knee cartilage defects may result in increased cartilage breakdown leading to decreased cartilage volume and joint space narrowing suggesting an important role for knee cartilage defects in early knee OA. (c) 2004 OsteoArthritis Research Society International. Published by Elsevier Ltd. All rights reserved.