通过磁共振成像在没有放射性关节炎的膝盖中观察了6年来早期的结构变化
Karin Magnusson1, Aleksandra Turkiewicz2, Jaanika Paemre3
1Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Orthopaedics, Clinical Epidemiology Unit, Lund, Remissgatan 4, Lund 222 42, Sweden; Norwegian Institute of Public Health, Cluster for Health Services Research, Sandakerveien 24C, Oslo 0473, Norway.
Osteoarthritis and cartilage
|December 8, 2025
概括
没有骨关节炎 (OA) 的膝盖的结构损伤很常见,特别是在骨骨关节 (PF) 关节. 磁共振成像 (MRI) 在六年内揭示了软骨,骨髓病变和脑膜的显著变化,而不考虑OA危险因素.
科学领域:
- 整形外科和运动医学
- 放射学和成像学 放射学和成像学
- 类风湿病学 类风湿病学
背景情况:
- 骨关节炎 (OA) 是一种退行性关节疾病,影响着全球数百万人.
- 早期发现和理解结构变化对于OA管理至关重要.
- 使用磁共振成像 (MRI) 的纵向研究为膝关节退化提供了洞察力.
研究的目的:
- 在基线没有放射性OA的个体中使用MRI研究膝关节关节区间的纵向变化.
- 为了比较结构变化的发生率在中间与侧面的小腿骨 (TF) 和腿骨 (PF) 区.
- 评估关节炎风险状况对膝盖结构损伤发展的影响.
主要方法:
- 340名45-55岁的患者 (骨关节炎倡议) 在基线和6年随访期间接受了膝盖MRI扫描.
- 使用MRI骨关节炎膝盖评分系统评估MRI扫描,以评估软骨,骨,骨髓病变 (BMLs) 和阴茎损伤.
- 统计分析 (混合效应波桑回归) 将结构变化的风险与各组件和OA风险状况进行了比较.
主要成果:
- 在6年内,89%的个体出现了增加的软骨损伤,75%出现了新的或恶化的骨髓病变 (BMLs),28%出现了阴道损伤.
- 与侧侧骨 (TF) 关节相比,骨 (PF) 关节的软骨损伤风险最高 (RR 2.4),骨质细胞 (RR 1.3) 和骨质瘤 (BML) (RR 2.8) 风险最高.
- 中间TF的阴茎损伤风险高于侧面TF (RR 2.8),有风险的膝盖显示阴茎损伤风险增加 (RR 1.8).
结论:
- 在大多数最初被归类为Kellgren-Lawrence等级0.0的膝盖中,膝盖结构损伤的进展显著.
- 这些变化不论是否存在骨关节炎的危险因素都会发生,这突显了广泛的亚临床退化.
- 骨骨关节是膝盖早期结构变化的主要部位,面临OA风险或发展OA.
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