髌下脂肪垫高信号强度对膝骨关节炎症状及结构的相关性

Correlation of high signal intensity of infrapatellar fat pad on symptoms and structure of knee osteoarthritis

目的基于影像数字化分析膝骨关节炎患者髌下脂肪垫(infrapatellar fat pad,IPFP)高信号强度与膝骨关节炎症状及结构改变的相关性。方法回顾性分析膝骨关节炎(knee osteoarthritis,KOA)的患者的影像学及临床资料。对比不同IPFP高信号强度患者膝骨关节炎症状和结构改变的差异,同时分析IPFP高信号强度变化与膝骨关节炎症状以及结构改变的关系。结果共收集并完成236例患者(294膝)的影像学测量和评估,以IPFP高信号强度中位数(27.40%)进行分组比较,IPFP高信号强度≥27.40%组在胫骨软骨损伤程度、膝关节角度变化、疼痛程度以及骨关节炎指数(western ontario and mcMaster universities osteoarthritis index,WOMAC)总分方面要显著高于与IPFP高信号强度<27.40%组,差异有统计学意义(P<0.05);IPFPF高信号强度变化与膝关节疼痛、关节线夹角(joint line convergence angle,JLCA)、膝关节kellgren-Lawrence(KL)分级以及股骨、胫骨软骨损伤程度存在显著正相关(P<0.05)。结论在KOA患者中,IPFP高信号强度改变与膝关节疼痛症状以及结构变化存在显著相关性,其可能是影响KOA进展的一个重要因素。

Objective To analyze the correlation between high signal intensity of infrapatellar fat pad(IPFP)and symptoms and structural changes of osteoarthritis of the knee in patients with osteoarthritis of the knee based on image digitization.Methods Imaging and clinical data of patients with knee osteoarthritis(KOA)were retrospectively analyzed.The differences in knee osteoarthritis symptoms and structural changes in patients with different IPFP high signal intensities were compared,and the relationship between IPFP high signal intensity changes and knee osteoar⁃thritis symptoms as well as structural changes was also analyzed.Results A total of 219 patients(268 knees)were collected and completed imaging measurements and evaluations,and the median IPFP high signal intensity(27.40%)was used to compare the groups.The IPFP high signal intensity≥27.40%group had a significantly higher degree of tibial cartilage damage,changes in knee angle,pain,and total scores on the osteoarthritis index(western ontario and mcMaster).universities osteoarthritis index(WOMAC)were significantly higher than those in the IPFP high signal intensity<27.40%group,with a statistically significant difference(P<0.05);IPFPF high signal inten⁃sity changes were associated with knee pain,joint line convergence angle,JLCA,and knee joint angle.Angle(JLCA),knee kellgren⁃Lawrence(KL)classification,and the degree of femoral and tibial cartilage damage were significantly positively correlated(P<0.05).Conclusion In patients with KOA,there is a significant correlation between IPFP high signal intensity changes and knee pain symptoms as well as structural changes,which may be an important factor influencing the progression of KOA.