Objective

To explore mechanisms of mechanoinflammation, we investigated the association between the presence of knee synovial perivascular edema and gait biomechanics that serve as surrogate measures of knee load in patients with knee osteoarthritis (OA).

Design

Patients with symptomatic, radiographic knee OA and neutral to varus alignment undergoing total knee arthroplasty or high tibial osteotomy participated in this cross-sectional analysis. All participants underwent 3D gait analysis prior to surgery. Synovial biopsies were obtained during surgery for histopathological assessment. The association between the presence of synovial perivascular edema (predictor) and the external knee moment (outcome) in each orthogonal plane was analyzed using multivariate linear regression and polynomial mixed effects regression models, while adjusting for age, sex, BMI, and gait speed.

Results

Ninety-two patients with complete gait and histopathological data were included. When fitted over 100% of stance, regression models indicated substantial differences between patients with and without synovial perivascular edema for knee moments in frontal, sagittal and transverse planes. The knee adduction moment was higher in patients with edema from 16 to 74% of stance, with the largest difference at 33% of stance (β = 6.87 Nm [95%CI 3.02, 10.72]); whereas the knee flexion-extension moment differed from 15 to 92% of stance, with the largest difference in extension at 60% of stance (β = −10.80 Nm [95%CI -16.20, −5.40]).

Conclusions

In patients with knee OA, the presence of synovial perivascular edema identified by histopathology is associated with aberrant patterns of knee loading throughout stance, supporting the link between biomechanics and synovial inflammation.

中文翻译：

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滑膜组织血管周围水肿与膝骨关节炎患者的步态模式改变有关

客观的

为了探索机械炎症的机制，我们研究了膝关节滑膜血管周围水肿的存在与作为膝关节骨性关节炎 (OA) 患者膝关节负荷的替代指标的步态生物力学之间的关联。

设计

接受全膝关节置换术或胫骨高位截骨术的有症状、影像学膝关节 OA 和中性至内翻对齐的患者参与了这项横断面分析。所有参与者在手术前都接受了 3D 步态分析。在手术期间获得滑膜活检用于组织病理学评估。使用多元线性回归和多项式混合效应回归模型分析了每个正交平面中滑膜血管周围水肿（预测因子）的存在与外部膝关节力矩（结果）之间的关联，同时调整了年龄、性别、BMI 和步态速度。

结果

包括 92 名具有完整步态和组织病理学数据的患者。当拟合超过 100% 的站姿时，回归模型表明，有和没有滑膜血管周围水肿的患者在正面、矢状和横向平面上的膝关节力矩存在显着差异。水肿患者的膝内收力矩在站立的 16% 至 74% 之间较高，在站立的 33% 时差异最大（β  = 6.87 Nm [95%CI 3.02, 10.72]）；而膝关节屈伸力矩在站立时的 15% 到 92% 之间存在差异，在站立的 60% 时，伸展的差异最大（β  = -10.80 Nm [95%CI -16.20, -5.40]）。

结论

在膝关节 OA 患者中，组织病理学确定的滑膜血管周围水肿的存在与整个站立过程中膝关节负荷的异常模式有关，这支持了生物力学和滑膜炎症之间的联系。