Topographic Patterns of Cartilage Lesions in Knee Osteoarthritis
Topographic Patterns of Cartilage Lesions in Knee Osteoarthritis
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DOI：
10.1177/1947603509354991
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发表时间：
2010-01-01
期刊：
影响因子：
2.8
通讯作者：
Sah, Robert L.
中科院分区：
文献类型：
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作者：
Bae, Won C.;Payanal, Melanie M.;Sah, Robert L.
目的：关节软骨病变的治疗可以受益于病变模式的表征及其进展为终末期骨关节炎。本研究的目的是确定，定量，在人类膝关节软骨病变的地形图模式。设计：对127个单侧远端股骨（来自109具尸体和18个关节置换术残留物）进行全层软骨病变的拍照。使用数字图像分析，定位病变，并确定髌股沟（PFG）和股骨外侧和内侧髁（分别为LFC和MFC）的标准化病变尺寸。使用每个隔室的病变大小的聚类分析将样本分类为模式。对于每种模式，创建显示病变范围和频率的地图。结果：发现4种主要类型（a-d）（各P < 0.001），病变大小从小（a）到不同区域（b-d）的大。模式B在MFC中具有主要病变（23%面积），并且在其他地方具有较小的病变（< 3%）。C型主要病变在LFC（19%）和MFC（10%）。模式d在PFG（15%）中有主要病变，在MFC（6%）和LFC（2%）中有较小的病变。a（a1-a3）的亚型具有相对较小的病变，a2与B之间以及a3与d之间具有相似性。结论：本发明的方法促进了基于病变大小和位置的全层软骨病变的不同地形图模式的定量识别。这些结果对使用精确的定量方法对骨关节炎患者进行分层具有意义，并且具有额外的纵向数据，针对软骨治疗。
Objective: Treatments for articular cartilage lesions could benefit from characterization of lesion patterns and their progression to end-stage osteoarthritis. The objective of this study was to identify, quantitatively, topographic patterns of cartilage lesions in the human knee. Design: Photographs were taken of 127 unilateral distal femora (from 109 cadavers and 18 arthroplasty remnants) with full-thickness cartilage lesions. Using digital image analysis, the lesions were localized, and normalized lesion size was determined for the patellofemoral groove (PFG) and the lateral and medial femoral condyles (LFC and MFC, respectively). Samples were classified into patterns using cluster analysis of the lesion size at each compartment. For each pattern, maps showing the extent and frequency of lesions were created. Results: Four main patterns (a-d) were identified (each P < 0.001), with the lesion size varying from small (a) to large in distinct regions (b-d). Pattern b had a predominant lesion (23% area) in the MFC and smaller (< 3%) lesions elsewhere. Pattern c had predominant lesions in the LFC (19%) and MFC (10%). Pattern d had a predominant lesion in the PFG (15%) and smaller lesions in the MFC (6%) and LFC (2%). The subpatterns of a (a1-a3) had relatively small lesions, with similarity between a2 and b and between a3 and d. Conclusion: The present methods facilitated quantitative identification of distinct topographic patterns of full-thickness cartilage lesions, based on lesion size and location. These results have implications for stratifying osteoarthritis patients using precise quantitative methods and, with additional longitudinal data, targeting cartilage treatments.