骨髓水肿面积影响自发性膝关节骨坏死保守治疗结果的研究

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摘要目的探讨骨髓水肿(bone marrow edema，BME)是否是自发性膝关节骨坏死(spontaneous osteonecrosis of the knee，SONK)保守治疗失败的影响因素。方法回顾性纳入西安市第五医院2020年5月至2020年10月门诊就诊的连续SONK患者90例，其中男11例，女79例；年龄45~76岁，平均(64.0±7.8)岁。依据初次就诊时膝关节BME面积的核磁分级标准，将患者分为低BME组和高BME组。患者经过限制负重和非災体消炎药物的保守治疗。随访1年内是否因膝关节疼痛而接受手术治疗，接受手术治疗即证明保守治疗失败。比较低BME组和高BME组两组的保守治疗失败率(接受手术治疗占总病例的比例)。结果高BME组的保守治疗失败率为75%，明显高于低BME组19%的保守治疗失败率，差异有统计学意义(χ2=28.46，P＜0.001)。结论本研究发现BME面积对于SONK的保守治疗效果有影响，BME面积较大者SONK的保守治疗失败率较高。

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	贺强
	黄小强
	孙彩虹

关键词 ：自发性膝关节骨坏死, 骨髓水肿, 保守治疗

Abstract：Objective The purpose of this study is to investigate whether bone marrow edema (BME) is a risk factor for the failure of conservative treatment of SONK.Methods A total of 90 consecutive cases of SONK in our hospital from May 2020 to October 2020 were retrospectively included.Those patients were divided into low BME group and high BME group according to the MRI grading standard of knee BME area at the first visit.The patients received conservative treatment with limited weight-bearing and non-steroidal anti-inflammatory drugs for one year.The patients were followed to confirm if they received surgical treatment due to knee pain.Surgical treatment means the failure of conservative treatment.The failure rate of conservative treatment was compared between low BME group and high BME group.The failure rate of conservative treatment was surgical treatment cases divided total of cases in high or low BME group.Results The failure rate of conservative treatment in high BME group (75%) was significantly higher than that in low BME group(19%).Conclusion Our study found that BME area had an effect on the conservativetreatment of SONK.The failure rate of conservative treatment of SONK patients with the larger BME area is much higher than ones with smaller BME area.

Key words： spontaneous osteonecrosis of the knee bone marrow edema conservative treatment

基金资助:西安市科技局一般项目(21YXYJ0053)

通讯作者: 孙彩虹

作者简介: 贺强(1983－ )，男，副主任医师，西安市第五医院骨科，heqianghonghui@163.com

引用本文:

贺强，黄小强，孙彩虹. 骨髓水肿面积影响自发性膝关节骨坏死保守治疗结果的研究[J]. 实用骨科杂志, 2022, 28(10): 944-.
He Qiang，Huang Xiaoqiang，Sun Caihong. A Study of the Effects of Bone Marrow Edema Area on Outcomes of Conservative Treatment of Spontaneous Osteonecrosis of the Knee. sygkzz, 2022, 28(10): 944-.

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http://www.sygkzz.com/CN/ 或 http://www.sygkzz.com/CN/Y2022/V28/I10/944

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