董继朝,李 明

膝关节骨关节炎是一种常见且多发的退行性疾病，严重影响患者生活质量，而软骨下骨囊肿作为其重要病变之一，近年来备受关注。国内外学者围绕软骨下骨囊肿展开了广泛研究。在成因方面，机械应力相关假说、滑液入侵假说以及其他潜在因素如炎症因子和代谢异常等被提出。病理特征上，从宏观病理表现到微观组织结构及分子生物学特征均有深入探讨。临床意义涵盖了膝关节疼痛和关节功能的影响。诊断方法包括影像学检查、实验室检查。治疗进展涉及保守治疗、手术治疗及新兴治疗技术。本研究全面梳理相关成果，为该领域进一步发展提供理论依据，以推动膝关节骨关节炎软骨下骨囊肿的精准诊疗研究。

膝关节骨关节炎；软骨下骨囊肿；治疗进展

[1] 陆锦炜,陈曦,叶陈毅,等.骨性关节炎中的软骨下骨囊肿:软骨下骨异常重建[J].中国组织工程研究,2019,23(32):5209-5215. [2] TÖNÜKŞB,YORGANCIOĞLU Z R,RAMADAN S U,等.Relationship between DXA measured systemic bone mineral density and subchondral bone cysts in postmenopausal female patients with knee osteoarthritis:a cross-sectional study :Osteoarthritis cysts and bone mineral density[J/OL].BMC musculoskeletal disorders,2024,25(1):50. [3] WANG W,DING R,ZHANG N,等.Subchondral bone cysts regress after correction of malalignment in knee osteoarthritis:comply with Wolff’s law[J/OL].International Orthopaedics,2021,45(2):445-451. [4] ANWAR A,HU Z,ZHANG Y,等.Multiple Subchondral Bone Cysts Cause Deterioration of Articular Cartilage in Medial OA of Knee:A 3D Simulation Study[J/OL].Frontiers in Bioengineering and Biotechnology,2020,8:573938. [5] CHEN Y,HU Y,YU Y E,等.Subchondral Trabecular Rod Loss and Plate Thickening in the Development of Osteoarthritis[J/OL].Journal of Bone and Mineral Research:The Official Journal of the American Society for Bone and Mineral Research,2018,33(2):316-327. [6] 华秉譞;阎作勤.骨关节炎软骨下骨的变化及其分子机制的研究进展[J].复旦学报(医学版),2017(02 vo 44):231-237. [7] HAN X,CUI J,XIE K,等.Association between knee alignment,osteoarthritis disease severity,and subchondral trabecular bone microarchitecture in patients with knee osteoarthritis:a cross-sectional study[J/OL].Arthritis Research&Therapy,2020,22(1):203. [8] CHEN Y,WANG T,GUAN M,等.Bone turnover and articular cartilage differences localized to subchondral cysts in knees with advanced osteoarthritis[J/OL].Osteoarthritis and Cartilage,2015,23(12):2174-2183. [9] CHAN P M B,WEN C,YANG W C,等.Is subchondral bone cyst formation in non-load-bearing region of osteoarthritic knee a vascular problem?[J/OL].Medical Hypotheses,2017,109:80-83. [10] KASPIRIS A,HADJIMICHAEL A C,LIANOU I,等.Subchondral Bone Cyst Development in Osteoarthritis:From Pathophysiology to Bone Microarchitecture Changes and Clinical Implementations[J/OL].Journal of Clinical Medicine,2023,12(3):815. [11] LI G,YIN J,GAO J,等.Subchondral bone in osteoarthritis:insight into risk factors and microstructural changes[J/OL].Arthritis Research&Therapy,2013,15(6):223. [12] MAGNUSSON K,TURKIEWICZ A,KUMM J,等.Relationship Between Magnetic Resonance Imaging Features and Knee Pain Over Six Years in Knees Without Radiographic Osteoarthritis at Baseline[J/OL].Arthritis Care&Research,2021,73(11):1659-1666. [13] BURNETT W D,KONTULAINEN S A,MCLENNAN C E,等.Knee osteoarthritis patients with more subchondral cysts have altered tibial subchondral bone mineral density[J/OL].BMC Musculoskeletal Disorders,2019,20:14. [14] MCERLAIN D D,ULICI V,DARLING M,等.An in vivo investigation of the initiation and progression of subchondral cysts in a rodent model of secondary osteoarthritis[J/OL].Arthritis Research&Therapy,2012,14(1):R26. [15] GARCELON C,ABASCAL J,OLIVIER C,等.Quantification of cartilage and subchondral bone cysts on knee specimens based on a spectral photon-counting computed tomography[J/OL].Scientific Reports,2023,13(1):11080. [16] HAYASHI D,XU L,ROEMER F W,等.Detection of Osteophytes and Subchondral Cysts in the Knee with Use of Tomosynthesis[J/OL].Radiology,2012,263(1):206-215.[17] MEIRLAEN S,HAOUDOU R,THITEUX Q,等.Treatment of bone cysts by percutaneous injection of demineralized bone matrix mixed with bone marrow[J/OL].Acta Orthopaedica Belgica,2022,88(3):559-567. [18] ZENG G J,FOONG W S,LIE T T D.Knee subchondroplasty for management of subchondral bone cysts:a novel treatment method[J/OL].Singapore Medical Journal,2021,62(9):492-496. [19] POTTY A G R,GUPTAA,RODRIGUEZ H C,等.Intraosseous Bioplasty for a Subchondral Cyst in the Lateral Condyle of Femur[J/OL].Journal of Clinical Medicine,2020,9(5):1358. [20] LIU D,MIAO Z,ZHANG W,等.Biomechanical analysis of different techniques for residual bone defect from tibial plateau bone cyst in total knee arthroplasty[J/OL].Frontiers in Bioengineering and Biotechnology,2024,12:1498882. [21] TANG Q,GUO S,DENG W,等.Using novel porous metal pillars for tibial bone defects in primary total knee arthroplasty[J/OL].BMC Musculoskeletal Disorders,2023,24:829. [22] ZHAO G,YAO S,MA J,等.The optimal angle of screw for using cement-screw technique to repair tibial defect in total knee arthroplasty:a finite element analysis[J/OL].Journal of Orthopaedic Surgery and Research,2022,17(1):363.

点击下载PDF