膝关节骨关节炎内侧间室软骨病损的MRI表现与关节镜术后疗效的相关性研究

目的探讨膝关节骨关节炎（OA）内侧间室软骨病损的MRI表现和关节镜手术后疗效的相关性及膝关节OA的关节镜手术适应证。方法对92例关节镜手术病例,其中男54例,女38例;年龄43～69岁,平均58.5岁。对患者膝关节股骨内髁和胫骨内侧平台软骨的MRI表现按ICRSMR分级标准进行分级,对所有患者均进行了术后12～30个月的随访,随访时进行Lysholm评分。结果 92例92个膝关节,核磁共振显示关节软骨损伤Ⅳ级10例;Ⅲ级16例;Ⅱ级20例;Ⅰ级25例;0级21例,分级的均数为（1.66±1.303）;术后Lysholm评分最高100分;最低64分,评分的均数（95.42±7.398）。术后Lysholm评分与ICRSMR分级相关系数r=-0.672,P〈0.05,统计学处理呈负相关。结论认为术前膝关节内侧间室软骨的MRI（1.5T）分级对膝关节OA关节镜手术指征的判断有重要的参考价值。

The relationship between cartilage injury degree confirmed by MRI and postoperative effect of arthroscope in knee osteoarthritis

Objective To analyze the indication of arthroscope by invesgating the correlation between cartilage injury degree confirmed by MRI and postoperative effect. Methods 92 cases were selected, among which, 54 were male, and 38 were female, aged from 43 to 69 years (mean 58.5 years). Arthrodial cartilage of knee was graded by ICRS MR, and follow-up was performed in 12-30 months after operation with recording Lysholm score. Results Among 92 knees, cartilage injury degree was graded as follows: grade Ⅳ in 10 cases, grade Ⅲ in 16 cases, grade Ⅱ in 20 cases, grade Ⅰ in 25 cases, grade zero in 21 cases; the mean grade was (1.66±1.303). Postoperative Lysholm score was 64 to 100 (average 95.42±7.398), the correlation coefficient was r=-0.672, P<0.05. There was a negative correlation tendency. Conclusion The patients with higher cartilage injury grade confirmed by MRI (1.5T) had worse effect after operation.The grade by MRI can provide important operation indication in arthroscope procedure.