PDF(Pubmed)
Abstract：
BACKGROUND: It is beneficial for society to discover the risk factors associated with surgery and to carry out some early interventions for patients with these risk factors. Few studies specifically explored the relationship between bone marrow lesions (BMLs) and long-term incident joint surgery.
OBJECTIVE: To investigate the association between BML severity observed in knee osteoarthritis (OA) patients\' first MRI examination and incident knee surgery within 5 years. Additionally, to assess the predictive value of BMLs for the incident knee surgery.
METHODS: Retrospective cohort study.
METHODS: We identified patients diagnosed with knee OA and treated at our institution between January 2015 and January 2018, and retrieved their baseline clinical data and first MRI examination films from the information system. Next, we proceeded to determine the Max BML grades, BML burden grades and Presence BML grades for the medial, lateral, patellofemoral, and total compartments, respectively. Multi-variable logistic regression models examined the association of the BML grades with 5-year incident knee surgery. Positive and negative predictive values (PPVs and NPVs) were determined for BML grades referring to 5-year incident knee surgery.
RESULTS: Totally, 1011 participants (knees) were found eligible to form the study population. Within the 5 years, surgery was performed on 74 knees. Max BML grade 2 and grade 3 of medial, patellofemoral and total compartments were strongly and significantly associated with incident surgery. None of the BML grades from lateral compartment was associated with incident surgery. The PPV was low and NPV was high for BMLs.
CONCLUSIONS: BMLs found in the first MRI examination were associated with 5-year incident joint surgery, except for those allocated in lateral compartments. The high NPVs imply that patients without BMLs have a low risk of requiring surgery within 5 years.
OBJECTIVE: To investigate the association between BML severity observed in knee osteoarthritis (OA) patients\' first MRI examination and incident knee surgery within 5 years. Additionally, to assess the predictive value of BMLs for the incident knee surgery.
METHODS: Retrospective cohort study.
METHODS: We identified patients diagnosed with knee OA and treated at our institution between January 2015 and January 2018, and retrieved their baseline clinical data and first MRI examination films from the information system. Next, we proceeded to determine the Max BML grades, BML burden grades and Presence BML grades for the medial, lateral, patellofemoral, and total compartments, respectively. Multi-variable logistic regression models examined the association of the BML grades with 5-year incident knee surgery. Positive and negative predictive values (PPVs and NPVs) were determined for BML grades referring to 5-year incident knee surgery.
RESULTS: Totally, 1011 participants (knees) were found eligible to form the study population. Within the 5 years, surgery was performed on 74 knees. Max BML grade 2 and grade 3 of medial, patellofemoral and total compartments were strongly and significantly associated with incident surgery. None of the BML grades from lateral compartment was associated with incident surgery. The PPV was low and NPV was high for BMLs.
CONCLUSIONS: BMLs found in the first MRI examination were associated with 5-year incident joint surgery, except for those allocated in lateral compartments. The high NPVs imply that patients without BMLs have a low risk of requiring surgery within 5 years.
摘要：
背景：发现与手术相关的危险因素，并对具有这些危险因素的患者进行一些早期干预，对社会是有益的。很少有研究专门探讨骨髓病变（BMLs）与长期意外关节手术之间的关系。
目的：探讨膝关节骨性关节炎（OA）患者首次MRI检查的BML严重程度与5年内膝关节手术的相关性。此外,评估BMLs对膝关节手术的预测价值。
方法：回顾性队列研究。
方法：我们确定了2015年1月至2018年1月在我们机构接受治疗的膝关节OA患者，并从信息系统中检索了他们的基线临床数据和第一份MRI检查片。接下来,我们继续确定最大BML等级，中间的BML负担等级和存在BML等级，横向,髌股,和总隔间，分别。多变量逻辑回归模型检查了BML等级与5年膝关节手术的相关性。确定BML等级的阳性和阴性预测值（PPV和NPV），涉及5年的膝关节手术。
结果：完全，发现1011名参与者(膝盖)有资格形成研究人群。五年之内,对74个膝盖进行了手术。最大BML2级和内侧3级，髌股和总室与意外手术密切相关。侧室的BML等级均与手术无关。BML的PPV低,NPV高。
结论：在第一次MRI检查中发现的BMLs与5年的意外关节手术有关，除了那些分配在侧室。高NPV意味着没有BML的患者在5年内需要手术的风险较低。
目的：探讨膝关节骨性关节炎（OA）患者首次MRI检查的BML严重程度与5年内膝关节手术的相关性。此外,评估BMLs对膝关节手术的预测价值。
方法：回顾性队列研究。
方法：我们确定了2015年1月至2018年1月在我们机构接受治疗的膝关节OA患者，并从信息系统中检索了他们的基线临床数据和第一份MRI检查片。接下来,我们继续确定最大BML等级，中间的BML负担等级和存在BML等级，横向,髌股,和总隔间，分别。多变量逻辑回归模型检查了BML等级与5年膝关节手术的相关性。确定BML等级的阳性和阴性预测值（PPV和NPV），涉及5年的膝关节手术。
结果：完全，发现1011名参与者(膝盖)有资格形成研究人群。五年之内,对74个膝盖进行了手术。最大BML2级和内侧3级，髌股和总室与意外手术密切相关。侧室的BML等级均与手术无关。BML的PPV低,NPV高。
结论：在第一次MRI检查中发现的BMLs与5年的意外关节手术有关，除了那些分配在侧室。高NPV意味着没有BML的患者在5年内需要手术的风险较低。
