髌下脂肪垫体积与膝骨性关节炎相关性研究

A cross-sectional study on correlation between volume of infrapatellar fat pad and knee osteoarthritis

[目的]探讨髌下脂肪垫(infrapatellar fat pad,IPFP)体积与膝关节骨关节炎(Keen Osteoarthritis,KOA)的关系。[方法]对体检职工进行横断面研究,排除膝关节外伤、感染、免疫性疾病后,共纳入114位受试者(114膝)行膝关节MRI扫描。利用mimics16.0处理T1加权图像测定IPFP体积;利用质子密度加权图像对膝关节软骨缺损、骨赘评分;利用WOMAC量表评估膝关节疼痛。分析IPFP体积与软骨缺损、骨赘、疼痛的相关性;并进一步把受试者分为OA组和对照组,比较组间IPFP体积差异性。[结果]多因素分析显示IPFP体积与股骨外侧、胫骨内侧、胫骨外侧、全膝关节骨赘及睡眠、平地行走时膝关节疼痛呈显著负相关;OA组IPFP体积小于非OA组,但差异无统计学意义。[结论]IPFP体积减少与膝关节退变有相关性,但KOA患者IPFP体积较健康人减少并不显著,提示力学作用可能不是IPFP影响KOA的主要途径。

[Objective] To investigate the relationship between volume of infrapatellar fat pad （IPFP） and knee osteo- arthritis （KOA） . [Method] After exclusion of knee trauma, infection and immunological diseases, 114persons （114 knees） were included in this cross-sectional study. As soon as MRI scan of the knee was performed in each subject, Mimicsl6.0 software was used to calculate IPFP volume in the Tl-weighted images, in addition, grade articular cartilage lesions and osteophytes in the proton density-weighted images. Furthermore, knee pain was assessed by WOMAC questionnaire. We analyzed the the correlation between IPFP volume and cartilage lesions, osteophyte as well as knee pain. The subjects were further divided into OA group and non-OA group to compare the differences of IPFP volume between them. [Results] The results of multivariate analysis showed that IPFP volume was negatively correlated with osteophyte of lateral femur, medial tib- ia, lateral tibia and total knee, as well as keen pain when sleeping and walking on flat surface. The IPFP volume of the OA group was smaller than the non-OA group, but the difference was not statistically significant. [Conclusion] Reduction of IPFP volume was associated with knee degeneration. IPFP volume of KOA patients was slightly less than healthy subjects, but the difference was not significant. This suggests that IPFP might not primarily affect KOA by mechanical mechanism.