CAJ | 학술논문

目的：对比性研究关节间隙狭窄（ mJSN）的骨性关节炎（ OA）患者中半月板的位置、形态与胫骨平台覆盖面大小的关系。方法选取60例单个膝关节原发性OA，选择标准为：双侧频繁性疼痛，国际骨性关节炎研究学会（ OARSI ）内侧关节间隙评级1～3级，而在对侧无关节间隙狭窄，在任一关节外侧无间隙狭窄。行冠状位3．0T核磁共振图像（ MRI）后，通过OARSI内侧间隙评级进行分组，分为mJSN1组及mJSN2/3组。通过MRI对胫骨平台和半月板进行三维立体定量分析，使用膝骨性关节炎分数（ MOAKS）对半月板的挤压情况进行半定量评估。采用配对t检验进行比较。结果 mJSN1组中，内侧胫骨平台覆盖范围为36％±9％，而在对侧无间隙狭窄的膝关节为45％±8％；mJSN2/3组中，内侧胫骨平台覆盖范围为31％±9％，而在对侧无间隙狭窄的膝关节为46％±6％（ P均＜0．001）。伴有mJSN的膝关节表现出更大的半月板挤压和损害，但在半月板体积方面没有显著差异。胫骨平台外侧覆盖面及外侧半月板形态或位置均无显著差异。结论伴有mJSN的胫骨平台内侧的半月板覆盖范围大幅减少，导致了关节软骨机械保护的减少，可能是mJSN的关节软骨磨损较高的原因之一。
목적：대비성연구관절간극협착（ mJSN）적골성관절염（ OA）환자중반월판적위치、형태여경골평태복개면대소적관계。방법선취60례단개슬관절원발성OA，선택표준위：쌍측빈번성동통，국제골성관절염연구학회（ OARSI ）내측관절간극평급1～3급，이재대측무관절간극협착，재임일관절외측무간극협착。행관상위3．0T핵자공진도상（ MRI）후，통과OARSI내측간극평급진행분조，분위mJSN1조급mJSN2/3조。통과MRI대경골평태화반월판진행삼유입체정량분석，사용슬골성관절염분수（ MOAKS）대반월판적제압정황진행반정량평고。채용배대t검험진행비교。결과 mJSN1조중，내측경골평태복개범위위36％±9％，이재대측무간극협착적슬관절위45％±8％；mJSN2/3조중，내측경골평태복개범위위31％±9％，이재대측무간극협착적슬관절위46％±6％（ P균＜0．001）。반유mJSN적슬관절표현출경대적반월판제압화손해，단재반월판체적방면몰유현저차이。경골평태외측복개면급외측반월판형태혹위치균무현저차이。결론반유mJSN적경골평태내측적반월판복개범위대폭감소，도치료관절연골궤계보호적감소，가능시mJSN적관절연골마손교고적원인지일。
Objective Comparative study of joint space narrowing ( mJSN) osteoarthritis ( OA) patients with meniscus position-morphology and surface of the tibial plateau covering relations size .Methods To select 60 cases of single primary knee OA ,inclusion criteria were:bilateral frequent pain ,Osteoarthritis Research Society International ( OARSI) rating grade 1~3 medial joint space ,and in the contralat-eral no joint space narrowing,at any no one outside of joint space narrowing .3.0T MRI coronal images(MRI),the medial gap rating by OAR-SI grouped into mJSN1 group and mJSN2/3 groups.By MRI of the tibial plateau and meniscus conduct three-dimensional quantitative analysis using knee osteoarthritis score ( MOAKS) meniscal extrusion conditions for semi-quantitative assessment .Paired T test was used for compari-son.Results mJSN1 group,the coverage of the tibial plateau medial joint space narrowing was 36%±9%,while the inside of the contralat-eral knee was no joint space narrowing 45%±8%,mJSN2/3 group,in the inside of the joint space narrowing was 31%±9%,while in the contralateral medial knee joint space narrowing was no 46%±6%(P<0.01).With mJSN exhibit greater knee meniscus extrusion and dam-age,but no significant differences in the volume of the meniscus .Outside the coverage of the tibial plateau and the lateral meniscus shape or location were not significantly different .Conclusion mJSN knee with Meniscus coverage medial tibial plateau significantly reduced ,resulting in a reduced mechanical protection of joint cartilage ,which may be one of the higher mJSN articular cartilage wear reasons .