膝关节超声结构参数与KOA患者临床严重程度和运动功能的相关性探讨

A Study on the Correlation between Ultrasonic Structural Parameters of the Knee Joint and Clinical Severity as well as Motor Function in Patients with KOA

摘要: 目的：探讨KOA患者临床严重程度和运动功能与内侧半月板突出程度(MME)、髌上软骨厚度、膝内上神经(SMGN)及膝内下神经(IMGN)超声结构参数的关系。方法：本研究选取了50例因KOA内侧疼痛就诊于青岛大学附属医院门诊及住院的患者的50个膝关节。采用视觉模拟评分量表(VAS)和西安大略和麦克马斯特大学骨关节炎指数(WOMAC)疼痛亚量表评估膝关节疼痛程度，WOMAC僵硬和功能亚量表评定日常生活能力，起立行走测试以及5米步行测试用于评估患者的运动功能。在超声检查中，评估软骨厚度、内侧半月板突出程度、膝内上神经(SMGN)及膝内下神经(IMGN)周围组织回升强度，并采用相关分析及回归分析，探讨其与KOA临床严重程度和运动功能之间的关系。结果：KOA患者内侧半月板突出程度、膝内上神经(SMGN)及膝内下神经(IMGN) EI值与临床严重程度和运动功能显著相关。结论：KOA患者内侧半月板突出程度、SMGN、IMGN周围组织回声强度的增加，会导致膝关节疼痛、症状加重和日常功能障碍。超声作为一种简单便携、价格低廉的检查方式，可以评估膝关节周围结构的改变与KOA的临床严重程度和运动功能的关系。

Abstract: Objective: To explore the relationship between the clinical severity and motor function of patients with knee osteoarthritis (KOA) and the degree of medial meniscus extrusion (MME), the thickness of the suprapatellar cartilage, and the ultrasound structural parameters of the superior medial genicular nerve (SMGN) and inferior medial genicular nerve (IMGN). Methods: This study included 50 knees from 50 patients who visited the outpatient clinic or were hospitalized at The Affiliated Hospital of Qingdao University due to medial knee pain caused by KOA. The visual analog scale (VAS) and the pain subscale of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were used to assess the degree of knee pain. The stiffness and function subscales of WOMAC were used to evaluate daily living abilities. The timed up-and-go test (TUG) and the 5-meter walk test (5MWT) were employed to assess motor function. During the ultrasound examination, cartilage thickness, the degree of medial meniscus extrusion, and the echogenicity of the perineural tissues of the SMGN and IMGN were evaluated. Correlation and regression analyses were performed to explore their relationships with the clinical severity and motor function of KOA. Results: In KOA patients, the degree of medial meniscus extrusion and the echogenicity (EI) values of the SMGN and IMGN were significantly correlated with clinical severity and motor function. Conclusion: Increased medial meniscus extrusion and higher perineural tissue echogenicity of the SMGN and IMGN in KOA patients are associated with worsening knee pain, symptoms, and limitations in daily activities. Ultrasound, as a simple, portable, and cost-effective examination method, can be used to evaluate the relationship between changes in periarticular knee structures and the clinical severity and motor function of KOA.