Knee cartilage defects in a sample of older adults: natural history, clinical significance and factors influencing change over 2.9 years
Knee cartilage defects in a sample of older adults: natural history, clinical significance and factors influencing change over 2.9 years
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DOI：
10.1016/j.joca.2012.08.026
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发表时间：
2012-12-01
影响因子：
7
通讯作者：
Jones, G.
中科院分区：
文献类型：
--
作者：
Carnes, J.;Stannus, O.;Jones, G.
目的：在一项对老年人的纵向研究中，描述膝关节软骨缺陷的自然历史及其与软骨体积丢失和膝关节置换风险的关系。设计：随机选择395名老年人(平均年龄62.7岁)，在基线和大约2.9年后对他们的右膝关节进行磁共振成像，以确定软骨缺陷级别(0-4)、软骨体积、胫骨内侧和外侧骨大小以及是否存在骨髓病变(BMLS)。按标准方案测量身高、体重、体重指数(BMI)和放射性骨关节炎。结果：在基线水平，较高级别的软骨缺陷(2级)与年龄、BMI、胫骨外侧骨大小、BMLS和放射性骨关节炎显著相关。在2.9年的时间里，所有间隔室的平均缺陷分数显著增加：然而，大多数缺陷保持稳定，缺陷的退化很少见。与2.9年后缺陷评分增加相关的基线因素是放射学上的骨关节炎、胫骨大小。体重指数和身为女性。在多因素分析中，基线软骨损伤分级预测2.9年以后胫骨内侧、胫骨外侧和膝盖骨的软骨体积丢失(β=-1.78%~-1.27%/年，P<；0.05)，以及5年后膝关节置换的风险(优势比(OR)=1.73每1级增加，P=0.001)。结论：老年人膝关节软骨损伤是常见的，但比年轻人更不容易退化。他们独立预测软骨体积的损失和膝关节置换的风险，表明它们是潜在的干预目标。(C)2012年国际骨性关节炎研究会。爱思唯尔有限公司出版。保留所有权利。
Objective: To describe the natural history of knee cartilage defects, and their relationship to cartilage volume loss and risk of knee replacement in a longitudinal study of older adults.Design: 395 randomly selected older adults (mean age 62.7 years) had magnetic resonance imaging of their right knee at baseline and approximately 2.9 years later to determine cartilage defect grade (0-4), cartilage volume, medial and lateral tibial bone size, and presence of bone marrow lesions (BMLs). Height, weight, body mass index (BMI) and radiographic osteoarthritis were measured by standard protocols.Results: At baseline higher grade cartilage defects (grade >= 2) were significantly associated with age, BMI, lateral tibial bone size, BMLs, and radiographic osteoarthritis. Over 2.9 years, the average defect score increased statistically significantly in all compartments: however, the majority of defects remained stable and regression of defects was rare. Baseline factors associated with increase in defect score over 2.9 years were radiographic osteoarthritis, tibial bone size. BMI and being female. In multivariate analysis, baseline cartilage defect grade predicted cartilage volume loss at the medial tibia, lateral tibia and patella over 2.9 years (beta = -1.78% to -1.27% per annum per 1 grade increase, P < 0.05 for all comparisons), and risk of knee replacement over 5 years (odds ratio (OR) = 1.73 per 1 grade increase, P = 0.001).Conclusion: Knee cartilage defects in older adults are common but less likely to regress than in younger life. They independently predict cartilage volume loss and risk of knee replacement, suggesting they are potential targets for intervention. (C) 2012 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.