医学检查与临床诊断

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

  • 宋雨珂 ,
  • 徐金凡 ,
  • 何晓铭 ,
  • 林天烨 ,
  • 何敏聪 ,
  • 邵敏 ,
  • 魏秋实
展开
  • 1.广州中医药大学第三附属医院关节中心 (广东 广州 510378 )
    2.广东省中医骨伤研究院 (广东 广州 510378 )
    3.广州中医药大学第三临床医学院 (广东 广州 510378 )

收稿日期: 2024-06-07

  网络出版日期: 2024-12-16

基金资助

广东省中医药局中医药科研项目(20233002);广东省新黄埔中医药联合创新研究院研究项目(2022IR012);广东省中医骨伤研究院开放基金项目(GYH20210203);广东省中医骨伤研究院青年基金项目(GYH20220101)

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

  • Yuke SONG ,
  • Jinfan XU ,
  • Xiaoming HE ,
  • Tianye LIN ,
  • Mincong HE ,
  • Qiushi. WEI
Expand
  • *.Joint Center,the Third Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510378,Guangdong,China
    *.Guangdong Research Institute for Orthopedics & Traumatology of Chinese Medicine,Guangzhou 510378,Guangdong,China

Received date: 2024-06-07

  Online published: 2024-12-16

摘要

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。

本文引用格式

宋雨珂 , 徐金凡 , 何晓铭 , 林天烨 , 何敏聪 , 邵敏 , 魏秋实 . 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[J]. 实用医学杂志, 2024 , 40(23) : 3373 -3378 . DOI: 10.3969/j.issn.1006-5725.2024.23.015

Abstract

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 osteoarthritis 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 intensity 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.

参考文献

1 孟庆奇,李斯明. 应重视骨性关节炎微环境中软骨损伤的修复[J]. 实用医学杂志,2019,35(7):1015-1018.
2 DAVIS J E, WARD R J, MACKAY J W, et al. Effusion-synovitis and infrapatellar fat pad signal intensity alteration differentiate accelerated knee osteoarthritis[J]. Rheumatology (Oxford),2019,58(3):418-426. doi:10.1093/rheumatology/key305
3 姚放鸣,何敏聪,何晓铭,等. 膝骨关节炎滑液脂质代谢特点的研究进展[J]. 实用医学杂志,2023,39(15):1992-1997.
4 TANG S, YAO L, RUAN J, et al. Single-cell atlas of human infrapatellar fat pad and synovium implicates APOE signaling in osteoarthritis pathology[J]. Sci Transl Med,2024,16(731):f4590. doi:10.1126/scitranslmed.adf4590
5 余江,冉学军,胡兆洋,等. 人工全膝关节置换术中髌下脂肪垫保留与否对患者术后的功能及伤口愈合影响[J]. 实用医学杂志,2021,37(22):2898-2902.
6 RASHID U, YOUSAF A, YAQOOB M, et al. Characterization and differentiation potential of mesenchymal stem cells isolated from multiple canine adipose tissue sources[J]. BMC Vet Res,2021,17(1):388. doi:10.1186/s12917-021-03100-8
7 YUE S, ZHAI G, ZHAO S, et al. The biphasic role of the infrapatellar fat pad in osteoarthritis[J]. Biomed Pharmacother,2024,179:117364. doi:10.1016/j.biopha.2024.117364
8 ZENG N, YAN Z P, CHEN X Y, et al. Infrapatellar Fat Pad and Knee Osteoarthritis[J]. Aging Dis,2020,11(5):1317-1328. doi:10.14336/ad.2019.1116
9 OLSSON S, AKBARIAN E, LIND A, et al. Automating classification of osteoarthritis according to Kellgren-Lawrence in the knee using deep learning in an unfiltered adult population[J]. BMC Musculoskelet Disord,2021,22(1):844. doi:10.1186/s12891-021-04722-7
10 蔡静玉,王康,徐建华,等. 骨关节炎髌下脂肪垫与软骨缺损的相关性研究[J]. 安徽医科大学学报,2015,50(10):1483-1486.
11 ALLAM E, BOYCHEV G, AIYEDIPE S, et al. Subchondral insufficiency fracture of the knee: Unicompartmental correlation to meniscal pathology and degree of chondrosis by MRI[J]. Skeletal Radiol,2021,50(11):2185-2194. doi:10.1007/s00256-021-03777-w
12 WU J, KUANG L, CHEN C, et al. miR-100-5p-abundant exosomes derived from infrapatellar fat pad MSCs protect articular cartilage and ameliorate gait abnormalities via inhibition of mTOR in osteoarthritis[J]. Biomaterials,2019,206:87-100. doi:10.1016/j.biomaterials.2019.03.022
13 SRIWATANANUKULKIT O, TAWONSAWATRUK T, RATTANAPINYOPITUK K, et al. Scaffold-Free Cartilage Construct from Infrapatellar Fat Pad Stem Cells for Cartilage Restoration[J]. Tissue Eng Part A,2022,28(5/6):199-211. doi:10.1089/ten.tea.2020.0167
14 顾玉彪,常瑞龙,雷宁波,等. 髌下脂肪垫与膝骨性关节炎相关性研究进展[J]. 中国疼痛医学杂志,2021,27(5):376-379.
15 WISNIEWSKA E, LAUE D, SPINNEN J, et al. Infrapatellar Fat Pad Modulates Osteoarthritis-Associated Cytokine and MMP Expression in Human Articular Chondrocytes[J]. Cells,2023,12(24):2850. doi:10.3390/cells12242850
16 BELLUZZI E, STOCCO E, POZZUOLI A, et al. Contribution of Infrapatellar Fat Pad and Synovial Membrane to Knee Osteoarthritis Pain[J]. Biomed Res Int,2019,2019:6390182. doi:10.1155/2019/6390182
17 瞿燕萍,高明霞,夏鹏,等. 膝骨关节炎脂肪垫对关节软骨细胞的影响[J]. 中国康复,2017,32(3):179-184.
18 CAO Y, RUAN J, KANG J, et al. Extracellular Vesicles in Infrapatellar Fat Pad from Osteoarthritis Patients Impair Cartilage Metabolism and Induce Senescence[J]. Adv Sci (Weinh),2024,11(3):e2303614. doi:10.1002/advs.202303614
19 HARKEY M S, DAVIS J E, LU B, et al. Early pre-radiographic structural pathology precedes the onset of accelerated knee osteoarthritis[J]. BMC Musculoskelet Disord,2019,20(1):241. doi:10.1186/s12891-019-2624-y
20 LYU L, REN J, LU W, et al. Association between quadriceps fat pad edema and patellofemoral osteoarthritis: A quantitative Q-Dixon-based magnetic resonance imaging (MRI) analysis[J]. Quant Imaging Med Surg,2024,14(5):3275-3288. doi:10.21037/qims-23-1730
21 WIDJAJAHAKIM R, ROUX M, JARRAYA M, et al. Relationship of Trochlear Morphology and Patellofemoral Joint Alignment to Superolateral Hoffa Fat Pad Edema on MR Images in Individuals with or at Risk for Osteoarthritis of the Knee: The MOST Study[J]. Radiology,2017,284(3):806-814. doi:10.1148/radiol.2017162342
22 陈小龙,赵衡,胡蓉,等. 髌下脂肪垫水肿与滑车及髌股关节形态相关性的MRI评估[J]. 中国组织工程研究,2021,25(15):2410-2415.
23 吴松,巴宏亮,何金深,等. 髌下脂肪垫MRI信号与膝关节骨关节炎相关性的横断面研究[J]. 中南大学学报(医学版),2017,42(5):536-541.
文章导航

/