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Slower Walking Speed Is Related to Early Femoral Trochlear Cartilage Degradation After ACL Reconstruction.
较慢的行走速度与ACL重建术后早期股骨滑车软骨退化有关。
- 影响因子:3.07
- DOI:10.1002/jor.24503
- 作者列表:"Capin JJ","Williams JR","Neal K","Khandha A","Durkee L","Ito N","Stefanik JJ","Snyder-Mackler L","Buchanan TS
- 发表时间:2020-03-01
Abstract
:Post-traumatic patellofemoral osteoarthritis (OA) is prevalent after anterior cruciate ligament reconstruction (ACLR) and early cartilage degradation may be especially common in the femoral trochlear cartilage. Determining the presence of and factors associated with early femoral trochlear cartilage degradation, a precursor to OA, is a critical preliminary step in identifying those at risk for patellofemoral OA development and designing interventions to combat the disease. Early cartilage degradation can be detected using quantitative magnetic resonance imaging measures, such as tissue T2 relaxation time. The purposes of this study were to (i) compare involved (ACLR) versus uninvolved (contralateral) femoral trochlear cartilage T2 relaxation times 6 months after ACLR, and (ii) determine the relationship between walking speed and walking mechanics 3 months after ACLR and femoral trochlear cartilage T2 relaxation times 6 months after ACLR. Twenty-six individuals (age 23 ± 7 years) after primary, unilateral ACLR participated in detailed motion analyses 3.3 ± 0.6 months after ACLR and quantitative magnetic resonance imaging 6.3 ± 0.5 months after ACLR. There were no limb differences in femoral trochlear cartilage T2 relaxation times. Slower walking speed was related to higher (worse) femoral trochlear cartilage T2 relaxation times in the involved limb (Pearson's r: -0.583, p = 0.002) and greater interlimb differences in trochlear T2 relaxation times (Pearson's r: -0.349, p = 0.080). Walking mechanics were weakly related to trochlear T2 relaxation times. Statement of clinical significance: Slower walking speed was by far the strongest predictor of worse femoral trochlear cartilage health, suggesting slow walking speed may be an early clinical indicator of future patellofemoral OA after ACLR. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 38:645-652, 2020.
摘要
: 创伤后髌股骨关节炎 (OA) 在前交叉韧带重建 (ACLR) 后普遍存在,早期软骨退化可能在股骨滑车软骨中尤其常见。确定与早期股骨滑车软骨降解 (OA的前体) 相关的因素和存在,是确定髌股OA风险人群和设计防治该疾病的干预措施的关键初步步骤。使用定量磁共振成像措施,如组织T2 弛豫时间,可以检测早期软骨降解。本研究的目的是 (i) 比较ACLR术后 6 个月受累 (ACLR) 与未受累 (对侧) 股骨滑车软骨T2 松弛时间,以及 (ii) 确定ACLR后 3 个月步行速度与步行力学的关系,以及ACLR后 6 个月股骨滑车软骨T2 弛豫时间。初级后 26 人 (年龄 23 ± 7 岁),单侧ACLR在ACLR后 3.3 ± 0.6 个月参与了详细的运动分析,在ACLR后 6.3 ± 0.5 个月参与了定量磁共振成像。股骨滑车软骨T2 弛豫时间无肢体差异。较慢的步行速度与受累肢体较高 (较差) 的股骨滑车软骨T2 松弛时间有关 (Pearson's r: -0.583,p = 0.002) 滑车T2 弛豫时间的肢间差异更大 (Pearson' s r: -0.349,p = 0.080)。行走力学与滑车T2 弛豫时间弱相关。临床意义声明: 步行速度较慢是股骨滑车软骨健康状况较差的最强预测因子,提示步行速度慢可能是ACLR后未来髌股OA的早期临床指标。©2019 骨科研究学会。由Wiley journals,Inc.发表J Orthop Res 38:645-652,2020。
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METHODS:OBJECTIVE:Patients with immune-mediated inflammatory diseases such as rheumatoid arthritis or systemic lupus erythematosus are at increased risk of cardiovascular disease. However, the cardiovascular risk of patients with primary Sjögren's syndrome (SS) remains poorly studied. We aimed to investigate the association between primary SS and cardiovascular morbidity and mortality. METHODS:We performed a systematic review of articles in Medline and the Cochrane Library and recent abstracts from US and European meetings, searching for reports of randomized controlled studies of cardiovascular morbidity and cardiovascular mortality in primary SS. The relative risk (RR) values for cardiovascular morbidity and mortality associated with primary SS were collected and pooled in a meta-analysis with a random-effects model by using Review Manager (Cochrane collaboration). RESULTS:The literature search revealed 484 articles and abstracts of interest; 14 studies (67,124 patients with primary SS) were included in the meta-analysis. With primary SS versus control populations, the risk was significantly increased for coronary morbidity (RR 1.34 [95% confidence interval (95% CI) 1.06-1.38]; P = 0.01), cerebrovascular morbidity (RR 1.46 [95% CI 1.43-1.49]; P < 0.00001), heart failure rate (odds ratio 2.54 [95% CI 1.30-4.97]; P < 0.007), and thromboembolic morbidity (RR 1.78 [95% CI 1.41-2.25]; P < 0.00001), with no statistically significant increased risk of cardiovascular mortality (RR 1.48 [95% CI 0.77-2.85]; P = 0.24). CONCLUSION:This meta-analysis demonstrates that primary SS is associated with increased cardiovascular morbidity, which suggests that these patients should be screened for cardiovascular comorbidities and considered for preventive interventions, in a multidisciplinary approach with cardiologists.
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各类骨关节疾病,包括退行性关节炎、滑囊炎、滑膜炎、颈椎病、腰椎病、肩周炎、骨质增生、风湿性关节炎、类风湿性关节炎、股骨头坏死等。