Objective:To observe the curative effect of release with needle knife combined with microporous decompression in bone marrow edema area of subchndral bone for treatment of knee osteoarthritis.Method:From March 2019 to...Objective:To observe the curative effect of release with needle knife combined with microporous decompression in bone marrow edema area of subchndral bone for treatment of knee osteoarthritis.Method:From March 2019 to March 2020,66 patients with knee osteoarthritis were selected as the research objects,and divided into treatment group and control group according to random nuber table.The treatment group was treated with release with needle knife combined with microporous decompression in bone marrow edema area,while the control group was treated with release with needle knife.Visual analogue scale(VAS),the Western Ontario and Mc Master University composite index(WOMCA)and inflammatory factors were used to evaluate the curative effect of patients before treatment and after treatment.Results:The VAS scores of knee pain in both groups decreased after treatment.The treatment group was lower than the control group.The WOMAC scores of both groups were decreased significantly after treatment,and then gradually decreased with time.The WOMAC scroes of the treatment group were lower than those of the control group after treatment,and there was an interactive effect on time factor.Conclusion:Release with needle knife combined with microporous decompression in bone marrow edema area of subchondral bone has good curative effect in the treatment of knee osteoarthritis;it can relieve the pain of patients,improve the function of joint,reduce inlfammatory reaction,and then delay the pathological progress of KOA,which is worthy of clinical promotion.展开更多
Bone marrow lesions (BMLs) on magnetic resonance (MR) images in knee osteoarthritis patients are considered to predict the severity and progression of the disease. We evaluated the histological findings of BMLs on MR ...Bone marrow lesions (BMLs) on magnetic resonance (MR) images in knee osteoarthritis patients are considered to predict the severity and progression of the disease. We evaluated the histological findings of BMLs on MR images of the subchondral area of the medial femoral condyle in varus osteoarthritic knees. In 24 patients with varus knee osteoarthritis who underwent total knee arthroplasty (TKA), sagittal T1- and T2-weighted MR images of the affected knee were acquired before TKA. During TKA, resected bone pieces from the distal medial femoral condyle were obtained. Sagittal specimens obtained from the center of the bone pieces were histologically examined. Twenty patients had BMLs. Histological findings of BMLs in the subchondral area showed various features, such as fibrovascular tissue, cyst formation, active bone remodeling with bone formation and bone resorption, and hyaline cartilage. BMLs were not found in four patients;histological findings of these patients showed normal bone marrow tissue with normal-thickness trabeculae. Subchondral bony end plate in knees with BMLs was usually thin or destroyed, while that without BMLs was thick or normal. The condition of the subchondral bony end plate would explain the differences in the severity and progression between patients with or without BMLs.展开更多
目的:探讨重度膝骨关节炎患者骨髓水肿与骨质疏松的关系。方法:采用非匹配型病例对照研究,自2020年1月至2021年3月收治已行膝关节MRI及双能X线吸收测定法(dualenergy X-ray absorptiometry,DXA)骨密度(bone mineral density,BMD)检查的...目的:探讨重度膝骨关节炎患者骨髓水肿与骨质疏松的关系。方法:采用非匹配型病例对照研究,自2020年1月至2021年3月收治已行膝关节MRI及双能X线吸收测定法(dualenergy X-ray absorptiometry,DXA)骨密度(bone mineral density,BMD)检查的160例重度膝骨关节炎患者,其中合并骨髓水肿的患者80例为骨髓水肿组,不合并骨髓水肿的患者80例为无骨髓水肿组。骨髓水肿组男12例,女68例;年龄51~80(66.58±8.10)岁;病程5~40(15.61±9.25)个月;身体质量指数(body mass index,BMI)21.81~34.70(27.79±3.00)kg·m^(-2);Kellgren-Lawrence(K-L)分级,Ⅲ级25例,Ⅳ级55例。无骨髓水肿组男15例,女65例;年龄50~80(67.82±8.05)岁;病程6~37(15.75±8.18)个月;BMI 21.39~34.46(28.26±3.13)kg·m^(-2);K-LⅢ级38例,Ⅳ级42例。采用膝关节整体磁共振成像评分(whole oragan magnetic resonance imaging score,WORMS)评价骨髓水肿程度,以DXA检查T值诊断骨质疏松、评价骨密度。比较两组患者骨质疏松的患病率,采用Spearman相关性分析骨髓水肿组患者骨髓水肿WORMS评分与DXA骨密度T值的相关性。结果:两组患者均于初诊时获得完整病例资料,无脱落或剔除,两组性别、年龄、病程、BMI比较,差异无统计学意义(P>0.05)。骨髓水肿患者K-LⅣ级所占比例高于无骨髓水肿组患者(P<0.05);骨髓水肿组患者骨质疏松患病率均分别高于同K-L等级中无骨髓水肿组患者,差异有统计学意义(P<0.05);骨髓水肿组患者骨髓水肿WORMS评分与DXA骨密度T值为强负相关(r=-0.812,|r|=0.812>0.8,P<0.001)。结论:骨质疏松是重度膝骨关节炎骨髓水肿的危险因素之一,骨密度越低越易导致骨髓水肿。展开更多
目的:探讨骨髓水肿与重度膝骨关节炎病理改变及症状体征的关系。方法:自2020年1月至2021年3月于中国中医科学院望京医院骨关节科就诊已行膝关节MRI检查的重度膝骨关节炎患者160例。合并骨髓水肿患者80例为病例组,男12例,女68例,年龄51~8...目的:探讨骨髓水肿与重度膝骨关节炎病理改变及症状体征的关系。方法:自2020年1月至2021年3月于中国中医科学院望京医院骨关节科就诊已行膝关节MRI检查的重度膝骨关节炎患者160例。合并骨髓水肿患者80例为病例组,男12例,女68例,年龄51~80(66.58±8.10)岁,病程5~40(15.61±9.25)个月,身体质量指数(body mass index,BMI)21.81~34.70(27.79±3.00)kg·m^(-2);不合并骨髓水肿的患者80例为对照组,男15例,女65例,年龄50~80(67.82±8.05)岁,病程6~37(15.75±8.18)个月,BMI 21.39~34.46(28.26±3.13)kg·m^(-2)。采用膝关节整体磁共振成像评分(whole oragan magnetic resonance imaging score,WORMS)评价骨髓水肿程度,采用Kellgren-Lawrence(K-L)等级、Western Outario and McMaster大学骨关节炎指数评分(Western Ontario and McMaster University osteoarthritis index,WOMAC)评价膝骨关节炎病变程度,采用视觉模拟评分(visual analogue scale,VAS),WOMAC疼痛评分评价关节疼痛程度,采用压痛、叩击痛、关节肿胀度、关节活动度评分评价关节体征。比较两组患者K-L等级分布的差异探讨骨髓水肿与膝骨关节炎病变程度的关系;并进一步通过Spearman相关性分析病例组患者骨髓水肿WORMS评分与WOMAC指数、疼痛相关评分、体征相关评分的相关系数,以进一步探讨骨髓水肿与膝骨关节炎指数、关节疼痛症状、体征的关系。结果:病例组患者K-L等级Ⅳ级者占68.75%(55/80),对照组患者等级Ⅳ级者占52.50%(42/80),病例组中Ⅳ级患者所占比例高于对照组(χ^(2)=4.425,P<0.05)。病例组患者骨髓水肿WORMS与膝骨关节炎WOMAC指数相关系数为强正相关(r=0.873>0.8,P<0.001),骨髓水肿WORMS与VAS相关系数r=0.752>0.5,与WOMAC量表疼痛评分相关系数r=0.650>0.5,为中度相关(P<0.001);骨髓水肿WORMS与叩击痛评分相关系数r=0.784>0.5,(P<0.001),为中度相关(P<0.05);骨髓水肿WORMS评分与压痛评分相关系数r=0.194<0.3、关节肿胀度评分相关系数r=0.259<0.3、关节活动度评分相关系数r=0.296<0.3,相关性极弱(P<0.05)。结论:膝骨关节炎病变越严重越容易引起骨髓水肿,同时骨髓水肿亦可加重膝骨关节炎病情;骨髓水肿可导致膝骨关节炎关节疼痛,叩击痛阳性体征,而压痛、关节肿胀、活动受限与骨髓水肿无明显相关。展开更多
基金Science and Technology Research Project in Kaifeng City,Henan Province Project approval:Science and Technology Research Project in Kaifeng City,Henan Province(1503005)。
文摘Objective:To observe the curative effect of release with needle knife combined with microporous decompression in bone marrow edema area of subchndral bone for treatment of knee osteoarthritis.Method:From March 2019 to March 2020,66 patients with knee osteoarthritis were selected as the research objects,and divided into treatment group and control group according to random nuber table.The treatment group was treated with release with needle knife combined with microporous decompression in bone marrow edema area,while the control group was treated with release with needle knife.Visual analogue scale(VAS),the Western Ontario and Mc Master University composite index(WOMCA)and inflammatory factors were used to evaluate the curative effect of patients before treatment and after treatment.Results:The VAS scores of knee pain in both groups decreased after treatment.The treatment group was lower than the control group.The WOMAC scores of both groups were decreased significantly after treatment,and then gradually decreased with time.The WOMAC scroes of the treatment group were lower than those of the control group after treatment,and there was an interactive effect on time factor.Conclusion:Release with needle knife combined with microporous decompression in bone marrow edema area of subchondral bone has good curative effect in the treatment of knee osteoarthritis;it can relieve the pain of patients,improve the function of joint,reduce inlfammatory reaction,and then delay the pathological progress of KOA,which is worthy of clinical promotion.
文摘Bone marrow lesions (BMLs) on magnetic resonance (MR) images in knee osteoarthritis patients are considered to predict the severity and progression of the disease. We evaluated the histological findings of BMLs on MR images of the subchondral area of the medial femoral condyle in varus osteoarthritic knees. In 24 patients with varus knee osteoarthritis who underwent total knee arthroplasty (TKA), sagittal T1- and T2-weighted MR images of the affected knee were acquired before TKA. During TKA, resected bone pieces from the distal medial femoral condyle were obtained. Sagittal specimens obtained from the center of the bone pieces were histologically examined. Twenty patients had BMLs. Histological findings of BMLs in the subchondral area showed various features, such as fibrovascular tissue, cyst formation, active bone remodeling with bone formation and bone resorption, and hyaline cartilage. BMLs were not found in four patients;histological findings of these patients showed normal bone marrow tissue with normal-thickness trabeculae. Subchondral bony end plate in knees with BMLs was usually thin or destroyed, while that without BMLs was thick or normal. The condition of the subchondral bony end plate would explain the differences in the severity and progression between patients with or without BMLs.
文摘目的:探讨重度膝骨关节炎患者骨髓水肿与骨质疏松的关系。方法:采用非匹配型病例对照研究,自2020年1月至2021年3月收治已行膝关节MRI及双能X线吸收测定法(dualenergy X-ray absorptiometry,DXA)骨密度(bone mineral density,BMD)检查的160例重度膝骨关节炎患者,其中合并骨髓水肿的患者80例为骨髓水肿组,不合并骨髓水肿的患者80例为无骨髓水肿组。骨髓水肿组男12例,女68例;年龄51~80(66.58±8.10)岁;病程5~40(15.61±9.25)个月;身体质量指数(body mass index,BMI)21.81~34.70(27.79±3.00)kg·m^(-2);Kellgren-Lawrence(K-L)分级,Ⅲ级25例,Ⅳ级55例。无骨髓水肿组男15例,女65例;年龄50~80(67.82±8.05)岁;病程6~37(15.75±8.18)个月;BMI 21.39~34.46(28.26±3.13)kg·m^(-2);K-LⅢ级38例,Ⅳ级42例。采用膝关节整体磁共振成像评分(whole oragan magnetic resonance imaging score,WORMS)评价骨髓水肿程度,以DXA检查T值诊断骨质疏松、评价骨密度。比较两组患者骨质疏松的患病率,采用Spearman相关性分析骨髓水肿组患者骨髓水肿WORMS评分与DXA骨密度T值的相关性。结果:两组患者均于初诊时获得完整病例资料,无脱落或剔除,两组性别、年龄、病程、BMI比较,差异无统计学意义(P>0.05)。骨髓水肿患者K-LⅣ级所占比例高于无骨髓水肿组患者(P<0.05);骨髓水肿组患者骨质疏松患病率均分别高于同K-L等级中无骨髓水肿组患者,差异有统计学意义(P<0.05);骨髓水肿组患者骨髓水肿WORMS评分与DXA骨密度T值为强负相关(r=-0.812,|r|=0.812>0.8,P<0.001)。结论:骨质疏松是重度膝骨关节炎骨髓水肿的危险因素之一,骨密度越低越易导致骨髓水肿。
文摘目的:探讨骨髓水肿与重度膝骨关节炎病理改变及症状体征的关系。方法:自2020年1月至2021年3月于中国中医科学院望京医院骨关节科就诊已行膝关节MRI检查的重度膝骨关节炎患者160例。合并骨髓水肿患者80例为病例组,男12例,女68例,年龄51~80(66.58±8.10)岁,病程5~40(15.61±9.25)个月,身体质量指数(body mass index,BMI)21.81~34.70(27.79±3.00)kg·m^(-2);不合并骨髓水肿的患者80例为对照组,男15例,女65例,年龄50~80(67.82±8.05)岁,病程6~37(15.75±8.18)个月,BMI 21.39~34.46(28.26±3.13)kg·m^(-2)。采用膝关节整体磁共振成像评分(whole oragan magnetic resonance imaging score,WORMS)评价骨髓水肿程度,采用Kellgren-Lawrence(K-L)等级、Western Outario and McMaster大学骨关节炎指数评分(Western Ontario and McMaster University osteoarthritis index,WOMAC)评价膝骨关节炎病变程度,采用视觉模拟评分(visual analogue scale,VAS),WOMAC疼痛评分评价关节疼痛程度,采用压痛、叩击痛、关节肿胀度、关节活动度评分评价关节体征。比较两组患者K-L等级分布的差异探讨骨髓水肿与膝骨关节炎病变程度的关系;并进一步通过Spearman相关性分析病例组患者骨髓水肿WORMS评分与WOMAC指数、疼痛相关评分、体征相关评分的相关系数,以进一步探讨骨髓水肿与膝骨关节炎指数、关节疼痛症状、体征的关系。结果:病例组患者K-L等级Ⅳ级者占68.75%(55/80),对照组患者等级Ⅳ级者占52.50%(42/80),病例组中Ⅳ级患者所占比例高于对照组(χ^(2)=4.425,P<0.05)。病例组患者骨髓水肿WORMS与膝骨关节炎WOMAC指数相关系数为强正相关(r=0.873>0.8,P<0.001),骨髓水肿WORMS与VAS相关系数r=0.752>0.5,与WOMAC量表疼痛评分相关系数r=0.650>0.5,为中度相关(P<0.001);骨髓水肿WORMS与叩击痛评分相关系数r=0.784>0.5,(P<0.001),为中度相关(P<0.05);骨髓水肿WORMS评分与压痛评分相关系数r=0.194<0.3、关节肿胀度评分相关系数r=0.259<0.3、关节活动度评分相关系数r=0.296<0.3,相关性极弱(P<0.05)。结论:膝骨关节炎病变越严重越容易引起骨髓水肿,同时骨髓水肿亦可加重膝骨关节炎病情;骨髓水肿可导致膝骨关节炎关节疼痛,叩击痛阳性体征,而压痛、关节肿胀、活动受限与骨髓水肿无明显相关。
