膝症状性骨关节炎335例临床分析

对335例膝骨关节炎(OA)临床分析结果显示:膝OA患病率随着增龄而增加,且病情也随之加重,部分可合并骨质疏松,并以女性多见。本组体块指数(BMI)平均值为26.1,有12％为肥胖,61％为超重。提示BMI过高是引起膝OA原因之一。以往临床不太重视的体征如骨摩擦音、骨关节肿胀等体征十分常见。因此,作好细致的体检,对提高本病的临床诊断有着重要意义。无论X线或MRI均可见病膝胫股关节的内侧部OA发生率较外侧部严重,可能与胫骨上端内翻、致承重线内移有关。MRI在显示关节结构以及早期诊断方面均优于X线。根据MRI特点可将膝OA分为三种类型,即①单纯型,②软组织型,③骨型。这将有利于提高对膝OA异质性的认识,达到治疗个体化的目的。

Clinical Analysis of 335 Patients with Symptomatic Osteoarthritis (OA) of Knee

Clinical analysis of 335 patients with symptomatic osteoarthritis of knee has shown an increasing severity and mobidity rate of OA with the advance in age, often complicated by osteoporosis (OP) . This is more commonly found in females than in males. The mean value of BMI was 26.1, 12% found in cases of obesity and 61 % in cases of overweight. This suggests that high values of BMI are one of the factors responsible for OA. Careful examination is therefore essential in the diagnosis of this disease. Both X-ray and MRI examinations revealed signs of greater severity in thd medial compartment of the tibiofemoral joint than in the lateral one, which was probably attributed to the proximal tibial inversion and/or the medial shift of the supporting line of gravity. MRI is superior to X - ray in that it provides better image of the structure of the joint and greater reliability of early diagnosis. In the light of MRI characteristics, OA may be classified into three types: the simple type, the soft tissue type and the bone type. This classification may be of help in the understanding of knee OA and individualized treatment.