半月板突出在膝骨性关节炎关节间隙狭窄中的作用

Effect of meniscal protrusion on the knee joint space narrowing with knee osteoa rthritis Huang

目的:探讨膝关节半月板突出在膝骨性关节炎(osteoarthritis,OA)的关节间隙狭窄中作用。方法:2003-01/2004-06对65骨关节炎膝及36正常自愿者膝在复旦大学附属华山医院骨科进行正侧位X射线检查和MRI扫描,根据X射线片进行内侧关节间隙Kellgren-Lawrence(K-L)分级,同时在MRI冠状面上评估内侧半月板突出程度。比较膝关节OA和正常膝关节半月板突出程度差异,并分析膝关节OA关节间隙狭窄和半月板突出的关系。结果:膝OA组K-L分级:Ⅰ级狭窄13膝、Ⅱ级狭窄19膝、Ⅲ级狭窄22膝、Ⅳ级狭窄8膝,对照组均为0级;膝OA组半月板突出:正常3膝,轻度突出16膝,中度突出20膝,重度突出23膝。对照组半月板突出:正常11膝,轻度突出20膝,中度突出5膝。OA组内侧半月板突出程度与正常对照组比较差异有显著性意义(P<0.01);骨关节炎组内不同K-L分级与内侧半月板突出程度有关系r=0.461,P<0.01)。(结论:内侧半月板突出是膝关节OA的一个重要特征,并且与关节间隙狭窄有关。

AIM:To evaluate the effect of meniscal protrusion on knee joint space narrowin g with knee osteoarthritis(OA). METHODS:From January 2003 to June 2004,65 patients with OA and 36 with normal knees were investigated by conventional radiographs at anterior and lateral posi tion, and magnetic resonance imaging(MRI) in the Department of Orthopaedics,Huas han Hospital Affiliated to Fudan University.Then based on the X ray radiographs ,medial joint space narrowing was assessed according to Kellgren Lawrence(K L) scoring system.The degree of medial meniscal protrusion was evaluated from coro nal surface of MRI.The degrees of medial meniscal protrusion were compared betwe en knee OA and normal controls,and the correlation of degree of meniscal protrus ion with joint space narrowing(K L Grade) was analyzed. RESULTS:There were 13 knees with K LⅠnarrowing,19 with K L Ⅱnarrowing,22 w ith K Ⅲnarrowing and 8 with K L Ⅳnarrowing in knee OA group,while all normal knees had normal joint space(K L Grade 0).There were 3 knees with normal menisc al protrusion,16 with mild meniscal protrusion,20 with moderate meniscal protrus ion and 23 with severe meniscal protrusion in knee OA group,while in the control group there were 11 knees with normal meniscal protrusion,20 with mild meniscal protrusion and 5 with moderate meinscal protrusion.The medial meniscal protrusi on degrees were significantly different between the two groups(P< 0.01).There wa s a relationship between different K L grades and degree of meniscal protrusion (r=0.461,P< 0.01). CONCLUSION:Medial meniscal protrusion,the major character of knee OA,correlate s with degree of joint space narrowing.