IF 2 4区医学 Q3 ORTHOPEDICS

Knee

Pub Date : 2025-12-23 DOI: 10.1016/j.knee.2025.104295

Zi-Ling Wang, Jian-Zhou Xie

引用次数: 0

Response to Letter to the Editor regarding "Imageless handheld robotic-assisted total knee arthroplasty showed better clinical outcomes than conventional total knee arthroplasty: A randomized controlled trial with preliminary results at 1-year follow up". 关于“无图像手持机器人辅助全膝关节置换术比传统全膝关节置换术的临床效果更好：一项随机对照试验，1年随访初步结果”的致编辑的回复。

IF 2 4区医学 Q3 ORTHOPEDICS

Knee

Pub Date : 2025-12-23 DOI: 10.1016/j.knee.2025.104296

Peter Bollars

引用次数: 0

Fixed versus mobile bearing medial unicompartmental knee arthroplasty with the same femoral implant design: a randomised controlled trial with a minimum of 10-year follow-up 采用相同股骨植入物设计的固定与移动承重内侧单室膝关节置换术：一项至少10年随访的随机对照试验。

IF 2 4区医学 Q3 ORTHOPEDICS

Knee

Pub Date : 2025-12-23 DOI: 10.1016/j.knee.2025.104304

Konstantinos Tsikopoulos , Konstantinos Kazamias , Paul White , James Robinson , John Newman , Andrew Porteous , James Murray

Background

The optimal bearing surface design for medial unicompartmental knee arthroplasty (UKA) has yet to be determined. In this randomised controlled trial from a single institution, we aimed to compare the clinical outcome, complications and joint survival of a single design femoral component medial UKA with either a fixed or mobile bearing tibial component from the same (Corin AMC, later rebranded Uniglide) implant system.

Methods

This was a prospective randomised trial with patients randomised to either fixed or mobile tibial components with the Uniglide system between 2006 and 2014. The primary outcome was patient reported outcome measure (PROM) using the Oxford Knee Score (OKS). Secondary outcomes were the American Knee Society Score (AKSS), the Western Ontario and McMaster University (WOMAC) arthritis index and the assessment of complications/reoperation.

Results

There were 163 primary UKAs. With a minimum 10-year follow-up there were 101 patients with PROM scores available (53 fixed vs 48 mobile); there was no statistically significant difference between the two groups (OKS 36.9 [11.2], n = 53 vs 36.8 [9], n = 48; p = 0.990). However, regarding the early revision by 10 years, there was a statistically significant lower chance in the fixed bearing group (risk ratio was found to be 0.42 [95 %CI 0.184 to 0.937; p = 0.030]).

Conclusions

This study shows comparable good clinical outcomes between fixed and mobile bearing UKA with a minimum of 10-year follow-up. However, higher revision rates were demonstrated in the mobile bearing group over the course of 10 years post-operatively.

背景：内侧单室膝关节置换术（UKA）的最佳承载面设计尚未确定。在这项来自单一机构的随机对照试验中，我们的目的是比较单一设计的股骨假体内侧UKA与来自相同（Corin AMC，后来更名为Uniglide）植入系统的固定或移动承重胫骨假体的临床结果、并发症和关节存活。方法：这是一项前瞻性随机试验，患者在2006年至2014年期间随机分配使用Uniglide系统的固定或活动胫骨组件。主要终点是使用牛津膝关节评分（OKS）的患者报告终点测量（PROM）。次要结果是美国膝关节协会评分（AKSS），西安大略省和麦克马斯特大学（WOMAC）关节炎指数和并发症/再手术评估。结果：原发性UKAs 163例。在至少10年的随访中，有101例患者获得PROM评分（53例固定对48例移动）；两组间差异无统计学意义（OKS 36.9 [11.2], n = 53 vs 36.8 [9], n = 48; p = 0.990）。然而，对于10年之前的修正，固定轴承组的风险比有统计学意义的低（风险比为0.42 [95% CI 0.184 ~ 0.937; p = 0.030]）。结论：该研究显示，至少10年随访后，固定和活动轴承UKA的临床结果相当良好。然而，在术后10年的过程中，活动轴承组的翻修率更高。

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引用次数: 0

External rotation of the patellar tendon insertion line: A novel predictor for recurrent patellar dislocation 髌骨肌腱止点线外旋：复发性髌骨脱位的新预测指标

IF 2 4区医学 Q3 ORTHOPEDICS

Knee

Pub Date : 2025-12-20 DOI: 10.1016/j.knee.2025.104302

Yasuhito Sogi , Masahiro Ohnuma , Kento Chikazawa , Mitsuhiro Kashiwaba , Masanori Ogasawara , Atsushi Takahashi , Takehiko Sugita , Toshimi Aizawa

Background

Recurrent patellar dislocation (RPD) is a multifactorial disorder, with tibial tuberosity lateralization (TTL) as a major contributor. Although the tibial tuberosity–trochlear groove (TT–TG) distance is widely used to assess TTL, it is influenced by knee flexion and trochlear dysplasia. Based on our clinical observation of increased external rotation of the patellar tendon insertion line in RPD, we hypothesized that this abnormality alters patellar vector forces. Currently, no parameter accounts for the rotational orientation of the patellar tendon insertion line. This study evaluated the patellar tendon insertion angle (PTIA) as a novel parameter, compared it with TT–TG distance, and investigated their associations with femorotibial rotation (FTR) and external tibial torsion (ETT).

Methods

Forty-eight patients with RPD and 50 control subjects were retrospectively analyzed using low dose computed tomography. TT–TG distance, PTIA, FTR, and ETT were measured. Diagnostic accuracy was evaluated using receiver operating characteristic curve analysis, and correlations between parameters were analyzed using Pearson’s coefficient.

Results

The TT–TG distance and PTIA were significantly greater in the RPD group than controls (TT–TG: 19.3 ± 3.7 mm vs. 16.1 ± 4.1 mm; p < 0.001; PTIA: 17.2 ± 4.5° vs. 9.9 ± 3.3°; p < 0.001). The PTIA showed higher diagnostic accuracy than the TT–TG distance. The TT–TG distance correlated positively with FTR, whereas PTIA correlated negatively. Neither parameter was associated with ETT.

Conclusion

The PTIA, a new tibia-based parameter, is significantly increased in RPD and demonstrates superior diagnostic accuracy compared with the TT–TG distance.

Level of evidence: Level IV, radiological cross-sectional study.

复发性髌骨脱位（RPD）是一种多因素疾病，胫骨结节偏侧化（TTL）是主要原因。虽然胫骨结节-滑车沟（TT-TG）距离被广泛用于评估TTL，但它受到膝关节屈曲和滑车发育不良的影响。根据我们对RPD患者髌骨肌腱止点线外旋增加的临床观察，我们假设这种异常改变了髌骨矢量力。目前，没有参数说明髌骨肌腱止点线的旋转方向。本研究评估了髌腱止点角（PTIA）作为一个新的参数，将其与TT-TG距离进行比较，并研究了它们与股胫旋转（FTR）和胫外扭转（ETT）的关系。方法对48例RPD患者和50例对照者进行低剂量计算机断层扫描回顾性分析。测量TT-TG距离、PTIA、FTR、ETT。采用受试者工作特征曲线分析评估诊断准确性，采用Pearson系数分析参数之间的相关性。结果RPD组TT-TG距离和PTIA显著高于对照组（TT-TG: 19.3±3.7 mm vs. 16.1±4.1 mm; p < 0.001; PTIA: 17.2±4.5°vs. 9.9±3.3°；p < 0.001）。PTIA的诊断准确率高于TT-TG距离。TT-TG距离与FTR呈正相关，PTIA呈负相关。这两个参数均与ETT无关。结论与TT-TG距离相比，PTIA作为一种新的胫骨参数，在RPD诊断中有显著提高，具有更高的诊断准确性。证据等级：IV级，放射横断面研究。

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引用次数: 0

Knee flexion during skin preparation improves anterior antiseptic coverage: A controlled fluorescent dye study 在皮肤准备期间膝关节屈曲改善前路防腐覆盖：一项对照荧光染料研究

IF 2 4区医学 Q3 ORTHOPEDICS

Knee

Pub Date : 2025-12-20 DOI: 10.1016/j.knee.2025.104300

Matthew McCann , Vivek Sharma , Mahbub Alam , Jehan Butt , Vishal Kumar

Background

Periprosthetic joint infection (PJI) is a rare but devastating complication of total knee arthroplasty (TKA) and a leading cause of TKA failure. Thorough skin preparation is a key preventative measure; however, the influence of limb position on antiseptic coverage has not been evaluated. This study compared the effectiveness of anterior knee antiseptic coverage in flexion and extension using a validated fluorescent dye model.

Methods

A prospective single-centre trial at Colchester General Hospital recruited ten healthy adult volunteers (20 knees) who underwent standardised preparation with 0.5 % chlorhexidine gluconate in 70 % ethanol after fluorescent dye application. The knees were prepared either in full extension or in maximal flexion in a fixed sequence. Ultraviolet (UV) imaging and digital analysis were used to quantify the residual dye as a surrogate for incomplete antiseptic coverage. Intra and interrater reliabilities were assessed using intraclass correlation coefficients (ICC).

Results

Eighty preparations (40 flexion, 40 extension) were analysed, with flexion yielding significantly less residual dye than extension (median [IQR: interquartile ratio] 1.7 % [IQR 0.1–7.2] vs. 9.8 % [IQR 2.6–19.0], p < 0.0001). The subgroup analysis confirmed consistent findings across both investigators. The intrarater reliability was good to excellent (ICC 0.62–0.89), whereas the interrater reliability was poor (ICC 0.07–0.35). No adverse events were reported.

Conclusion

Maximal knee flexion during skin preparation significantly improved anterior surface antiseptic coverage compared with extension. This simple, cost-neutral modification can be readily incorporated into TKA workflows, as we have done previously. Further studies with microbiological endpoints and broader patient populations are warranted to establish the effect on PJI prevention.

背景：假体周围关节感染（PJI）是全膝关节置换术（TKA）中一种罕见但毁灭性的并发症，也是TKA失败的主要原因。彻底的皮肤准备是关键的预防措施；然而，肢体位置对抗菌覆盖的影响尚未得到评估。本研究采用一种经过验证的荧光染料模型，比较了膝关节前侧抗菌剂覆盖在屈曲和伸展中的有效性。方法在科尔切斯特综合医院进行了一项前瞻性单中心试验，招募了10名健康成人志愿者（20个膝关节），在荧光染料应用后，采用0.5%葡萄糖酸氯己定与70%乙醇的标准化制备。膝关节按固定顺序完全伸展或最大屈曲。紫外线（UV）成像和数字分析用于量化残留染料作为不完全防腐覆盖的替代。使用类内相关系数（ICC）评估组内和组间信度。结果对80种制剂（40种屈曲制剂，40种伸曲制剂）进行分析，屈曲制剂的残留染料产量显著低于伸曲制剂（中位数[IQR：四分位数比]1.7% [IQR 0.1-7.2]对9.8% [IQR 2.6-19.0], p < 0.0001）。亚组分析证实了两位研究者的一致发现。量表内信度为良至优（ICC 0.62 ~ 0.89），量表间信度较差（ICC 0.07 ~ 0.35）。无不良事件报告。结论膝关节最大屈曲与伸直相比，可显著提高前表面抗菌覆盖。这个简单的、成本中立的修改可以很容易地合并到TKA工作流中，正如我们之前所做的那样。有必要进一步研究微生物终点和更广泛的患者群体，以确定PJI预防的效果。

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引用次数: 0

Comparisons of muscle strength and power in females with above and below average hamstrings-to-quadriceps ratio across the velocity spectrum 在速度谱中，腿筋与股四头肌之比高于和低于平均水平的女性肌肉力量和力量的比较

IF 2 4区医学 Q3 ORTHOPEDICS

Knee

Pub Date : 2025-12-20 DOI: 10.1016/j.knee.2025.104299

Samantha Searles , Adam Knight , Harish Chander , Zachary Gillen

Background/purpose

Females with above average hamstrings-to-quadriceps ratio (HTQ) will have superior peak torque (PT), mean power (MP), and HTQ compared to those with below average HTQ.

Methods

27 college-aged females participated. PT and MP was taken from maximal voluntary isometric contractions (MVICs) and isokinetic knee extensions and flexions performed at 60–300°·s⁻¹ for each leg. HTQ was the ratio of PT from knee flexion and extension. Subjects were separated into above and below average HTQ groups for each leg and velocity. ANOVAs examined differences in HTQ, PT, and MP across groups and velocities.

Results

The above average group had greater HTQ across velocity (p ≤ 0.002) but both groups had the same response where HTQ was the same from MVIC-60°·s⁻¹, increased from 60 to 120°·s⁻¹, and plateaued 120–300°·s⁻¹. Knee extension PT was greater for the below average group (p < 0.030). For both groups, PT decreased across velocity (p ≤ 0.005). Knee flexion PT was highest at MVIC followed by a decrease from 60 to 300°·s⁻¹ for all groups (p < 0.001). For both groups, PT decreased across velocity (p < 0.005). Knee extension MP was greater for the below average group (p < 0.001). For both groups, MP increased from 60 to 180°·s⁻¹ (p < 0.001) and plateaued from 180 to 300°·s⁻¹ (p = 1.000). Knee flexion MP was greater for the above average group (p ≤ 0.013). For both groups, MP increased from 60 to 120°·s⁻¹ (p < 0.001), plateaued from120 to 240°·s⁻¹ (p = 1.000), decreased from 240 to 300°·s⁻¹ (p > 0.426).

Conclusions

Above or below HTQ has minimal impact on torque and power production as velocity increases, and should be used with other metrics for injury risk.

背景/目的：与低于平均水平的女性相比，腿筋与股四头肌之比（HTQ）高于平均水平的女性将具有更高的峰值扭矩（PT）、平均功率（MP）和HTQ。方法27名女大学生参与。PT和MP取自每条腿在60-300°·s−1下进行的最大自主等距收缩（mvic）和等速膝关节伸展和屈曲。HTQ为膝关节屈伸PT的比值。每条腿和速度将受试者分为高于和低于平均HTQ组。方差分析分析了不同组和速度之间HTQ、PT和MP的差异。结果上述平均组的HTQ跨速度较大（p≤0.002），但两组的反应相同，从MVIC-60°·s−1开始HTQ从60°·s−1增加到120°·s−1，并稳定在120°- 300°·s−1。低于平均水平组的膝关节伸展PT更大（p < 0.030）。两组PT均随速度变化而降低（p≤0.005）。所有组的膝关节屈曲PT在MVIC时最高，随后从60°·s−1降至300°·s−1 （p < 0.001）。两组PT均随速度变化而降低（p < 0.005）。低于平均水平组的膝关节伸展MP更大（p < 0.001）。两组的MP均从60°·s−1增加到180°·s−1 (p < 0.001)，并在180°·s−1至300°·s−1之间保持稳定（p = 1.000）。膝关节屈曲MP高于平均水平组（p≤0.013）。两组的MP均从60°·s−1增加到120°·s−1 (p > 0.001)，从120°·s−1增加到240°·s−1 (p = 1.000)，从240°·s−1减少到300°·s−1 （p > 0.426）。结论随着速度的增加，高于或低于HTQ对扭矩和功率产生的影响最小，应与其他伤害风险指标一起使用。

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引用次数: 0

Mechanism of muscle activation in the protection of knee joint injury during jogging 慢跑时肌肉激活保护膝关节损伤的机制

IF 2 4区医学 Q3 ORTHOPEDICS

Knee

Pub Date : 2025-12-20 DOI: 10.1016/j.knee.2025.104307

Jiangtao Ruan , Kai Cui , Yangyang Meng , Xia Xiao

Background

It is important to understand the role of muscle activation in knee joint protection against the injuries, such as meniscus tear, cartilage wear, and ligament damage, often caused by muscle weakness, improper running posture, or overtraining. Research on the finite element knee model with muscles has not been reported yet, nor have there been any biomechanical explorations on the internal tissues of knee joint with muscle activation.

Objective

To explore the mechanism of muscle activation in jogging for the protection against knee joint injuries based on the stress fields of the knee internal tissues.

Methods

A finite element knee joint model with muscles (Vastus lateralis, vastus medialis, and vastus intermedius) was established. The stress fields of knee internal tissues during jogging were numerically simulated and investigated to explore the mechanism of muscle activation in knee protection against injury.

Results

Activation of muscle forces reduces peak stress on joint tissues, diminishes stress concentration, and enhances the load-bearing capacity of the knee joint. The proportion of contact area in the lateral tissues is increased, which means activating the muscle forces adjusts the load-bearing mode of the knee joint by involving the lateral tissues to participate in sharing the loads with the medial tissues, thus improve the stability of the knee joint.

Conclusion

Activation of muscle forces in jogging improves the load-bearing capacity and stability of the knee joint by reducing peak stress on joint tissues, decreasing the proportion of concentrated area, increasing the contact area in lateral tissues, and involving lateral tissues in sharing loads with medial tissues.

了解肌肉激活在膝关节保护中所起的作用是很重要的，这些损伤通常是由肌肉无力、不正确的跑步姿势或过度训练引起的，如半月板撕裂、软骨磨损和韧带损伤。对有肌肉的膝关节有限元模型的研究尚未见报道，对有肌肉激活的膝关节内部组织的生物力学探索也尚未见报道。目的从膝关节内部组织应力场的角度探讨慢跑时肌肉激活对膝关节损伤的保护作用机制。方法建立具有股外侧肌、股内侧肌和股中间肌的膝关节有限元模型。通过数值模拟和研究慢跑时膝关节内部组织的应力场，探讨肌肉激活在膝关节损伤保护中的作用机制。结果肌肉力量的激活降低了关节组织的峰值应力，减少了应力集中，提高了膝关节的承重能力。外侧组织接触面积的比例增加，即激活肌力，通过外侧组织参与与内侧组织分担负荷，调整膝关节的承重方式，从而提高膝关节的稳定性。结论慢跑时肌肉力量的激活，通过降低关节组织的峰值应力、减少集中面积的比例、增加外侧组织的接触面积、使外侧组织与内侧组织分担负荷，提高膝关节的负重能力和稳定性。

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引用次数: 0

Long-term outcomes and predictors of failure after medial opening-wedge high tibial osteotomy: a 138-knee cohort with up to 10-year follow-up 内侧开楔形胫骨高位截骨术后的长期预后和失败预测因素：138个膝关节队列，随访10年。

IF 2 4区医学 Q3 ORTHOPEDICS

Knee

Pub Date : 2025-12-20 DOI: 10.1016/j.knee.2025.104303

Juan Miguel Gómez-Palomo , Juan José García-Vera , Amparo Zamora-Mogollo , Carmen Tara-Abad , Ana Martínez-Crespo , Elvira Montañez-Heredia

Purpose

To quantify 10-year survivorship after medial opening-wedge high tibial osteotomy (MOWHTO) and identify modifiable predictors of conversion to total knee arthroplasty (TKA), focusing on joint-line obliquity (JLO), obesity and smoking.

Methods

Single-centre retrospective cohort of 138 MOWHTOs (2007–2022) with Ahlbäck I–II medial osteoarthritis, correctable varus and ≥24-month follow-up. Long-leg radiographs measured alignment, JLO (tibial plateau angle relative to floor) and medial proximal tibial angle (MPTA; pre-/post-operative). Primary outcome: TKA conversion. Kaplan–Meier estimated survivorship; multivariable Cox with proportional-hazards checks and Fine–Gray competing-risk analyses were used. A sensitivity model added post-operative JLO and deviation from planned hip–knee–ankle (HKA) alignment; a complementary model evaluated post-operative MPTA >95°.

Results

Mean age 46.9 years; mean follow-up 83.4 months. Twelve of 138 knees (8.7 %) underwent TKA; survivorship was 98.5 % at 2 years, 90.4 % at 5 years and 79.7 % at 10 years. Independent predictors of conversion were age (HR 1.09/year), BMI ≥30 (HR 1.12), smoking (HR 2.85) and pre-operative JLO >5° (HR 1.32) (all p < 0.05). Post-operative MPTA >95° was not significant. Findings were consistent in competing-risk analyses. Complications occurred in 13.0 % (hinge fracture 5.1 %, delayed/non-union 3.6 %, infection 4.3 %). WOMAC improved from 45.8 to 22.1 (p < 0.001); all KOOS domains improved (p < 0.001); satisfaction 86.2 %.

Conclusions

MOWHTO achieved ∼80 % 10-year TKA-free survivorship with durable functional gains. Older age, obesity, smoking and increased pre-operative JLO predicted earlier conversion; post-operative MPTA >95° was not significant. Considering MPTA thresholds alongside pre-operative JLO may help avoid excessive obliquity and optimise longevity.

Level of evidence: Level IV (retrospective cohort/case series).

目的：量化内侧开楔形高位胫骨截骨术（MOWHTO）后的10年生存率，并确定转换为全膝关节置换术（TKA）的可改变预测因素，重点是关节线倾角（JLO）、肥胖和吸烟。方法：单中心回顾性队列研究138例（2007-2022）患有Ahlbäck I-II型内侧骨关节炎、可矫正内翻的MOWHTOs患者，随访≥24个月。长腿x线片测量对齐，JLO（胫骨平台相对于底的角度）和内侧胫骨近端角度（MPTA；术前/术后）。主要结局：TKA转换。Kaplan-Meier估计存活率；采用多变量Cox、比例风险检验和Fine-Gray竞争风险分析。灵敏度模型增加了术后JLO和偏离计划髋关节-膝关节-踝关节（HKA）对准；补充模型评估术后MPTA bb0 95°。结果：平均年龄46.9岁；平均随访83.4个月。138例膝关节中12例（8.7%）行全膝关节置换术；2年生存率为98.5%，5年为90.4%，10年为79.7%。转换的独立预测因子为年龄（HR 1.09/年）、BMI≥30 （HR 1.12）、吸烟（HR 2.85）和术前JLO bb0.5°（HR 1.32）（p 95°均无统计学意义）。竞争风险分析的结果是一致的。并发症发生率为13.0%（铰链骨折5.1%，延迟/不愈合3.6%，感染4.3%）。WOMAC从45.8提高到22.1 (p)。结论：MOWHTO实现了约80%的10年无tka生存率和持久的功能获益。年龄较大、肥胖、吸烟和术前JLO增加预测早期转化；术后MPTA >95°无明显差异。考虑MPTA阈值与术前JLO可能有助于避免过度倾斜和优化寿命。证据等级：四级（回顾性队列/病例系列）。

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引用次数: 0

Variations in graft maturity between quadriceps tendon and semitendinosus tendon at 6 months after anterior cruciate ligament reconstruction: A quantitative assessment using UTE-T2* mapping 前交叉韧带重建后6个月股四头肌肌腱和半腱肌腱间移植物成熟度的变化：使用UTE-T2*制图的定量评估

IF 2 4区医学 Q3 ORTHOPEDICS

Knee

Pub Date : 2025-12-19 DOI: 10.1016/j.knee.2025.104298

Yoshihiro Ishida , Yasushi Takata , Rikuto Yoshimizu , Yusuke Yanatori , Naoki Takemoto , Miho Okuda , Yu Ueda , Satoru Demura , Junsuke Nakase

Background

The semitendinosus (ST) tendon is commonly used as a graft in anterior cruciate ligament (ACL) reconstruction. However, there is growing interest in the quadriceps tendon (QT). The reconstructed ACL undergoes a remodeling process, and its tissue quality is an important factor in determining when to return to sports activities. It remains unclear whether there are differences in tissue quality between QT and ST grafts at the same postoperative stage. UTE-T2* mapping has gained attention as a method for quantitatively evaluating the organization of the reconstructed ACL. This study aimed to reveal differences in tissue quality and collagen organization between QT and ST grafts at 6 months after ACL reconstruction using UTE-T2* mapping.

Methods

In this retrospective comparative study, twenty patients who had undergone ACL reconstruction using the QT and ST were included. UTE-T2* mapping was performed 6 months after surgery. T2* value was measured at intraarticular, femoral tunnel and tibial tunnel site. Each value were compared between the two groups (The Mann–Whitney U test).

Results

In the QT group, the T2* values were 11.8 ± 1.3 ms (intra-articular), 7.8 ± 1.6 ms (tibial), and 8.9 ± 1.5 ms (femoral). In the ST group, the corresponding UTE-T2* values were 11.1 ± 2.2 ms, 7.5 ± 1.9 ms, and 10.8 ± 1.6 ms, respectively. Notably, a significant difference was observed between the two groups in the femoral site (P = 0.026).

Conclusions

QT grafts were more mature than ST grafts within the femoral tunnel six months after ACL reconstruction.

背景：半腱肌（ST）肌腱是前交叉韧带（ACL）重建中常用的移植物。然而，人们对股四头肌肌腱（QT）的兴趣越来越大。重建的前交叉韧带经历了一个重塑过程，其组织质量是决定何时恢复体育活动的重要因素。目前尚不清楚QT移植和ST移植在同一术后阶段的组织质量是否存在差异。作为一种定量评价重建ACL组织的方法，UTE-T2*映射已受到关注。本研究旨在通过UTE-T2*作图揭示ACL重建后6个月QT和ST移植的组织质量和胶原组织的差异。方法回顾性比较分析20例采用QT和ST行ACL重建的患者。术后6个月进行UTE-T2*测绘。在关节内、股骨隧道和胫骨隧道处测量T2*值。比较两组间各值（Mann-Whitney U检验）。结果QT组T2*值分别为关节内（11.8±1.3 ms）、胫骨（7.8±1.6 ms）、股骨（8.9±1.5 ms）。ST组对应的UTE-T2*值分别为11.1±2.2 ms、7.5±1.9 ms和10.8±1.6 ms。值得注意的是，两组在股骨部位的差异有统计学意义（P = 0.026）。结论前交叉韧带重建6个月后，在股骨隧道内，sqt移植比ST移植更成熟。

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引用次数: 0

Thrombospondin-4 correlates with MRI measures of structural damage and pain sensitisation: a new biomarker in knee osteoarthritis 血栓反应蛋白-4与结构损伤和疼痛致敏的MRI测量相关：膝关节骨关节炎的新生物标志物

IF 2 4区医学 Q3 ORTHOPEDICS

Knee

Pub Date : 2025-12-19 DOI: 10.1016/j.knee.2025.104305

Franklyn Arron Howe , Soraya Koushesh , Anna Blundell , Amber Law , Abiola Harrison , Vivian Ejindu , Seyi Taylor-Kuti , Andisheh Niakan , Mary Sheppard , Richard Ljuhar , Nidhi Sofat

Background

We hypothesised thrombospondin-4 (TSP-4), a molecule mediating pain sensitisation in peripheral nerve injury, is associated with pain sensitisation in OA.

Methods

A cross-sectional study of clinical, imaging and fluid biomarkers from knee OA participants was conducted. TSP-4 was assessed by immunohistochemistry (IHC) for OA tissue samples and by ELISA in serum samples. Type II collagen degradation products (CTX-II), linked to OA structural damage, was determined from urine samples. A general linear model (GLM) was used to: a) investigate how patient-reported WOMAC (Western Ontario and McMaster Universities OsteoArthritis Index) pain/stiffness subscales and pain sensitisation measured by painDETECT, related to the Hospital Anxiety and Depression Scale (HADS), structural damage quantified from MRI and X-rays, CTX-II and TSP-4; b) how TSP-4 related to structural damage. We used linear discriminant analysis (LDA) to determine a classifier for pain-sensitisation from clinical and wet-biomarkers.

Results

TSP-4 was expressed in cartilage, bone marrow lesion (BML) and synovial tissue from OA samples. Upregulated TSP-4 protein was observed in cartilage, synovial tissue and BMLs in a perivascular distribution and in fibrotic tissue. Serum TSP-4 was significantly higher (p = 0.001) in those with pain sensitisation (painDETECT level ≥19) compared with non-sensitised participants. Serum TSP-4 was significantly increased with Hoffa’s synovitis (p < 0.001) and number of BMLs (p < 0.001 to p < 0.05). LDA provided classification accuracy of 80 % for pain sensitisation using TSP-4, CTX-II and HADS, supporting the biopsychosocial model of pain in OA.

Conclusion

Our data suggests TSP-4 is associated with pain sensitisation in OA and is a biomarker stratifying for pain sensitisation.

我们假设血小板反应蛋白-4 (TSP-4)，一种介导周围神经损伤疼痛致敏的分子，与OA疼痛致敏有关。方法对膝关节OA患者的临床、影像学和液体生物标志物进行横断面研究。用免疫组化法（IHC）检测OA组织样本中的TSP-4，用ELISA检测血清样本中的TSP-4。II型胶原降解产物（CTX-II）与OA结构损伤有关，从尿液样本中测定。一般线性模型（GLM）用于：A)调查患者报告的WOMAC（西安大略省和麦克马斯特大学骨关节炎指数）疼痛/僵硬亚量表和疼痛致敏性，与医院焦虑和抑郁量表（HADS）、MRI和x射线量化的结构损伤、CTX-II和TSP-4相关；b) TSP-4与结构损伤的关系。我们使用线性判别分析（LDA）从临床和湿生物标志物中确定疼痛敏感的分类器。结果stsp -4在骨性关节炎软骨、骨髓病变（BML）和滑膜组织中均有表达。在血管周围分布的软骨组织、滑膜组织和bml组织以及纤维化组织中观察到TSP-4蛋白上调。与非致敏组相比，疼痛致敏组（painDETECT水平≥19）血清TSP-4显著升高（p = 0.001）。血清TSP-4在Hoffa滑膜炎（p < 0.001）和bml数量（p < 0.001 ~ p < 0.05）中显著升高。LDA使用TSP-4、CTX-II和HADS对疼痛致敏的分类准确率为80%，支持OA疼痛的生物心理社会模型。结论：我们的数据表明，TSP-4与OA患者的疼痛致敏有关，是疼痛致敏的生物标志物。

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