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膝骨性关节炎的影像学表现与关节镜术后疗效的相关性研究
Hits: 3029   Download times: 1453   Received:August 15, 2010    
作者Author单位UnitE-Mail
杨光 YANG Guang 诸暨市人民医院骨科, 浙江 诸暨 311800
2.浙江大学医学院附属第二医院骨科
Department of Orthopaedics, the People's Hospital of Zhuji, Zhuji 311800, Zhejiang, China zjzjyg@yahoo.com.cn 
严世贵 YAN Shi-gui 浙江大学医学院附属第二医院骨科  
冯建钜 FENG Jian-ju 诸暨市人民医院骨科, 浙江 诸暨 311800 Department of Orthopaedics, the People's Hospital of Zhuji, Zhuji 311800, Zhejiang, China  
王叶军 WANG Ye-jun 诸暨市人民医院骨科, 浙江 诸暨 311800 Department of Orthopaedics, the People's Hospital of Zhuji, Zhuji 311800, Zhejiang, China  
钟建平 ZHONG Jian-ping 诸暨市人民医院骨科, 浙江 诸暨 311800 Department of Orthopaedics, the People's Hospital of Zhuji, Zhuji 311800, Zhejiang, China  
刘铁民 LIU Tie-min 诸暨市人民医院骨科, 浙江 诸暨 311800 Department of Orthopaedics, the People's Hospital of Zhuji, Zhuji 311800, Zhejiang, China  
马云淼 MA Yun-miao 诸暨市人民医院骨科, 浙江 诸暨 311800 Department of Orthopaedics, the People's Hospital of Zhuji, Zhuji 311800, Zhejiang, China  
高志洋 GAO Zhi-yang 诸暨市人民医院骨科, 浙江 诸暨 311800 Department of Orthopaedics, the People's Hospital of Zhuji, Zhuji 311800, Zhejiang, China  
徐铁烽 XU Tie-feng 诸暨市人民医院骨科, 浙江 诸暨 311800 Department of Orthopaedics, the People's Hospital of Zhuji, Zhuji 311800, Zhejiang, China  
期刊信息:《中国骨伤》2010年23卷,第12期,第899-902页
DOI:10.3969/j.issn.1003-0034.2010.12.005
基金项目:浙江省医药卫生科学研究基金(编号:2008A158)


目的:寻找膝骨性关节炎的影像学表现和关节镜手术后疗效的相关性,对膝骨性关节炎的关节镜手术适应证进行探讨。

方法:2005年8月至2008年4月,收集86例关节镜手术病例,其中男44例,女42例;年龄46~67岁,平均56.3岁。对患者膝关节核磁共振片按ICRS MR分级标准进行分级,对患者膝关节站立位X线片按K/L评分(Kellgren Lawrence grade) 标准进行分级,对所有患者进行了术后随访,时间12~30个月,随访时进行Lysholm评分。

结果:86例86个膝关节,核磁共振显示关节软骨损伤4级30例,3级22例,2级20例,1级12例,0级2例,分级的均数为(2.77±1.138)级;膝关节站立位X线片显示4级0例,3级24例,2级38例,1级17例,0级7例,分度的均数为(2.13±0.67)级;术后Lysholm评分59~100分,平均(95.17±7.556)分。术后Lysholm评分与ICRS MR分级的Kendall's相关系数为-0.089,P=0.317,无相关性;术后Lysholm评分与K/L分度的Kendall's相关系数为-0.851,P= 0.036,呈负相关。

结论:术前膝关节软骨的MRI(1.5T)分级不能作为关节镜手术指征判断的金标准,术前膝关节软骨的MRI(1.5T)分级与患者术后疗效无相关性,而膝关节站立位X线片有重要的参考价值。
[关键词]:骨关节炎,膝  磁共振成像  放射摄影术  关节镜检查
 
Study on the correlation between knee osteoarthritis imaging and effects of arthroscope
Abstract:

Objective: To explore the indications of arthroscope for the treatment of knee osteoarthritis and investigate the correlation between knee osteoarthritis imaging and effects of arthroscope.

Methods: From 2005.8 to 2008.4,86 patients with knee osteoarthritis underwent arthroscope examination and treatment. Among the patients,44 patients were male, and 42 patients were female,ranging in age from 46 to 67 years, averaged 56.3 years. Arthrodial cartilage of knee was graded by ICRS MR,and by Kellgern Laqrence X-ray. All the patients were followed up,and the duration ranged from 12 to 30 months. The Lysholm score was evaluated at the follow-up time.

Results: Among 86 knees in 86 cases,cartilage injury degree of knees was graded as follows:grade 4 in 30 cases,grade 3 in 22 cases,grade 2 in 20 cases,grade 1 in 12 cases,grade 0 in 2 cases,mean grade(2.77±1.138). Postoperative Lysholm score ranged from 59 to 100,averaged(95.17±7.556),Kendall's correlation coefficient was -0.089,P=0.317. There was no correlations between cartilage injury degree and Lysholm score. X-ray of knees was graded as follows:grade 4 in 0 cases,grade 3 in 24 cases,grade 2 in 38 cases,grade 1 in 17 cases,grade 0 in 7 cases,mean grade was(2.13± 0.67),the Kendall's correlation coefficient was -0.851 with negative correlations(P= 0.036) between postoperative Lysholm score and K/L grade.

Conclusion: There is no correlation between the grade of knee cartilage injury confirmed by MRI(1.5T) and effects of arthroscopy,and the grade is not a gold standard as an operation indication in arthroscope procedure. The K/L grade in X-ray had important effects.
KEYWORDS:Osteoarthritis, knee  Magnetic resonance imaging  Radiography  Arthroscopy
 
引用本文,请按以下格式著录参考文献:
中文格式:杨光,严世贵,冯建钜,王叶军,钟建平,刘铁民,马云淼,高志洋,徐铁烽.膝骨性关节炎的影像学表现与关节镜术后疗效的相关性研究[J].中国骨伤,2010,23(12):899~902
英文格式:YANG Guang,YAN Shi-gui,FENG Jian-ju,WANG Ye-jun,ZHONG Jian-ping,LIU Tie-min,MA Yun-miao,GAO Zhi-yang,XU Tie-feng.Study on the correlation between knee osteoarthritis imaging and effects of arthroscope[J].zhongguo gu shang / China J Orthop Trauma ,2010,23(12):899~902
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