膝骨关节炎患者髌下脂肪垫高信号面积与内翻畸形的相关性分析

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摘要目的基于影像数字化分析膝骨关节炎患者的髌下脂肪垫(infrapatellar fat pad，IPFP)高信号面积与内翻畸形改变的相关性。方法回顾性分析自2020年5月至2022年5月于广州中医药大学第三附属医院关节中心住院治疗的320例(379膝)膝骨关节炎(knee osteoarthritis，OA)患者的影像学及临床资料。其中男73例(81膝)，女247例(298膝)；年龄40~86岁，平均(65.04±8.56)岁；病程(5.37±5.46)年。根据膝关节KellgrenLawrence(KL)分级将患者分为轻度退变组(KL Ⅱ级)，中度退变组(K-L Ⅲ级)和重度退变组(K-L Ⅳ级)，分别对比三组患者MRI矢状位平面IPFP面积和IPFP高信号面积，并分别分析IPFP面积和IPFP高信号面积与下肢骨骼参数的相关性。结果在IPFP面积方面，轻度退变组(586.08±108.99) mm²、中度退变组(570.75±90.73) mm²和重度退变组(577.35±102.07) mm²，组间比较差异无统计学意义(P＞0.05)；在IPFP高信号面积方面，轻度退变组(159.33±50.31) mm²、中度退变组(153.54±58.00) mm²和重度退变组(178.81±57.87) mm²，组间比较差异有统计学意义(P＜0.05)；IPFP面积与下肢力线参数无明显相关性(P＞0.05)，IPFP高信号面积与髋膝踝角(hip-knee-ankle angle，HKA)和关节线夹角(joint line convergence angle，JLCA)存在显著相关性(P＜0.05)。结论 IPFP高信号面积与膝关节退变程度以及内翻畸形角度具有一定相关性，其可能是影响膝骨关节炎进展的一个潜在因素。

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	宋雨珂
	郭海威
	洪志楠
	林天烨
	何晓铭
	何敏聪
	陈庆真
	魏秋实

关键词 ：膝骨关节炎, 内翻畸形, 髌下脂肪垫, 高信号, 下肢力线

Abstract：

Objective To analyze the correlation between the high signal area of infrapatellar fat pad (IPFP) and the change of varus deformity in patients with osteoarthritis of the knee based on image digitization.Methods The imaging and clinical data of 320(379 knees) patients with knee osteoarthritis (knee osteoarthritis，OA) hospitalized in the Joint Center of the Third Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine from May 2020 to May 2022 were retrospectively analyzed.Among them，73 cases (81 knees) were male and 247 cases (298 knees) were female，with ages ranging from 40 to 86 years，average of (65.04±8.56) years，and the illness cause of (5.37±5.46) years.According to the KellgrenLawrence (K-L) grading of the knee joints，the patients were classified into mild degeneration group (K-L grade Ⅱ)，moderate degeneration group (K-L grade Ⅲ) and severe degeneration group (K-L grade Ⅳ).The MRI sagittal plane IPFP area and IPFP high signal area of the patients in the three groups were compared and analyzed separately，and the correlation between IPFP area，IPFP high signal area and lower limb skeletal parameters was also studied.Results In terms of IPFP area，there was no statistically significant difference between groups in the mild degeneration group (586.08±108.99) mm²，moderate degeneration group (570.75±90.73) mm² and severe degeneration group (577.35±102.07) mm² (P＞0.05).In terms of IPFP high signal area，there was no statistically significant difference between groups in the mild degeneration group (159.33±50.31) mm²，moderate degeneration group (153.54±58.00) mm² and severe degeneration group (178.81±57.87) mm²；and in terms of IPFP high signal area.The differences between groups were not statistically significant (P＜0.05).There was no significant correlation between the IPFP area and the force line parameters of the lower limbs (P＞0.05)，and the high signal area of the IPFP had no significant correlation with the hip-knee ankle Angle (HKA) and joint line convergence angle (JLCA) were significantly correlated (P＜0.05).Conclusion The IPFP high signal area correlates with the degree of knee degeneration and the angle of internal derangement，which may be a potential factor influencing the progression of knee osteoarthritis.

Key words： knee osteoarthritis varus deformity infrapatellar fat pad high signal lower limb alignment

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青年基金(GYH20220101)

通讯作者: 魏秋实

作者简介: 宋雨珂(1992－ )，男，医师，广州中医药大学第三附属医院关节中心，459684614@qq.com

引用本文:

宋雨珂，郭海威，洪志楠，林天烨，何晓铭，何敏聪，陈庆真，魏秋实. 膝骨关节炎患者髌下脂肪垫高信号面积与内翻畸形的相关性分析[J]. 实用骨科杂志, 2023, 29(9): 792-.
Song Yuke，Guo Haiwei，Hong Zhinan，Lin Tianye，He Xiaoming，He Mincong，Chen Qingzhen，Wei Qiushi. Correlation Between High Signal Area of Infrapatellar Fat Pad and Varus Deformity in Patients with Knee Osteoarthritis. sygkzz, 2023, 29(9): 792-.

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http://www.sygkzz.com/CN/ 或 http://www.sygkzz.com/CN/Y2023/V29/I9/792

［1］Sharma L.Osteoarthritis of the knee［J］.N Engl J Med，2021，384(1)：51-59.
［2］张程，吴忠书，李子祺，等.膝骨关节炎与骨质疏松症的相关性研究进展［J］.中国骨质疏松杂志，2021，27(4)：618-624.
［3］Zeng N，Yan ZP，Chen XY，et al.Infrapatellar fat pad and knee osteoarthritis［J］.Aging Dis，2020，11(5)：1317-1328.
［4］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.
［5］Belluzzi E，El HH，Granzotto M，et al.Systemic and local adipose tissue in knee osteoarthritis［J］.J Cell Physiol，2017，232(8)：1971-1978.
［6］Bohnsack M，Meier F，Walter GF，et al.Distribution of substanceP nerves inside the infrapatellar fat pad and the adjacent synovial tissue：A neurohistological approach to anterior knee pain syndrome［J］.Arch Orthop Trauma Surg，2005，125(9)：592-597.
［7］Do AR，Almeida HV，Kelly DJ，et al.Infrapatellar fat pad stem cells：From developmental biology to cell therapy［J］.Stem Cells Int，2017(2017)：6843727.
［8］Garcia J，Mennan C，Mccarthy HS，-et al.Chondrogenic potency analyses of donormatched chondrocytes and mesenchymal stem cells derived from bone marrow，infrapatellar fat pad，and subcutaneous fat［J］.Stem Cells Int，2016(2016)：6969726.
［9］Ushiyama T，Chano T，Inoue K，et al.Cytokine production in the infrapatellar fat pad：Another source of cytokines in knee synovial fluids［J］.Ann Rheum Dis，2003，62(2)：108-112.
［10］周佐清，朱兆华，汤苏安，等.膝骨关节炎中局部脂肪组织的作用及其研究进展［J］.中华医学杂志，2019(33)：2637-2640.
［11］Pan F，Han W，Wang X，et al.A longitudinal study of the association between infrapatellar fat pad maximal area and changes in knee symptoms and structure in older adults［J］.Ann Rheum Dis，2015，74(10)：1818-1824.
［12］Cai J，Xu J，Wang K，et al.Association between infrapatellar fat pad volume and knee structural changes in patients with knee osteoarthritis［J］.J Rheumatol，2015，42(10)：1878-1884.
［13］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.
［14］Wang K，Ding C，Hannon M J，et al.Signal intensity alteration within infrapatellar fat pad predicts knee replacement within 5 years：Data from the osteoarthritis initiative［J］.Osteoarthritis Cartilage，2018，26(10)：1345-1350.
［15］Favero M，ElHadi H，Belluzzi E，et al.Infrapatellar fat pad features in osteoarthritis：A histopathological and molecular study［J］.Rheumatology (Oxford)，2017，56(10)：1784-1793.
［16］谢鹏，刘华，王文强，等.胫骨高位截骨相关数据的健康人群测量［J］.中国矫形外科杂志，2022，30(18)：1680-1684.
［17］Damen J，van Rijn RM，Emans PJ，et al.Prevalence and development of hip and knee osteoarthritis according to American college of rheumatology criteria in the CHECK cohort［J］.Arthritis Res Ther，2019，21(1)：4.
［18］Kohn MD，Sassoon AA，Fernando ND.Classifications in brief：KellgrenLawrence classification of osteoarthritis［J］.Clin Orthop Relat Res，2016，474(8)：1886-1893.
［19］Ioan-Facsinay A，Kloppenburg M.An emerging player in knee osteoarthritis：the infrapatellar fat pad［J］.Arthritis Res Ther，2013，15(6)：225.
［20］陈墅，刘宁，周义钦，等.髌下脂肪垫在膝骨关节炎发病和进展中的作用［J］.中华骨科杂志，2018，38(15)：953-960.
［21］Ruhdorfer A，Haniel F，Petersohn T，et al.Between group differences in infrapatellar fat pad size and signal in symptomatic and radiographic progression of knee osteoarthritis vs non-progressive controls and healthy kneesdata from the FNIH biomarkers consortium study and the osteoarthritis initiative［J］.Osteoarthritis Cartilage，2017，25(7)：1114-1121.
［22］Han W，Aitken D，Zheng S，et al.Association between quantitatively measured infrapatellar fat pad high signalintensity alteration and magnetic resonance imagingassessed progression of knee osteoarthritis［J］.Arthritis Care Res (Hoboken)，2019，71(5)：638-646.
［23］Chang J，Liao Z，Lu M，et al.Systemic and local adipose tissue in knee osteoarthritis［J］.Osteoarthritis Cartilage，2018，26(7)：864-871.
［24］Xie C，Chen Q.Adipokines：New therapeutic target for osteoarthritis?［J］.Curr Rheumatol Rep，2019，21(12)：71.
［25］Stocco E，Barbon S，Piccione M，et al.Infrapatellar fat pad stem cells responsiveness to microenvironment in osteoarthritis：From morphology to function［J］.Front Cell Dev Biol，2019(7)：323.
［26］杜丹，付佳，杨曦，等.膝骨关节炎患者膝内翻畸形的影响因素分析［J］.中医正骨，2022，34(11)：32-36.
［27］李健雄，张程，辛鹏飞，等.膝骨关节炎疼痛机制研究进展［J］.中华关节外科杂志(电子版)，2021，15(5)：596-600.