Objective. To assess the association of bone mineral density (BMD) of the femoral and tibial condyles with knee pain and disease severity in women with symptomatic medial knee osteoarthritis (OA). Methods. We enrolled 192 women (ages 41-90 years) between April 2007 and March 2011. The subjects were divided into 2 groups according to joint space narrowing (JSN) on weight-bearing radiographs. BMD of the lumbar spine, proximal femur, and knee condyles was measured. Medial and lateral condyle BMDs of the femur and tibia as well as the medial versus lateral condyle BMD ratios were measured. Results. Mean medial condyle BMDs, medial versus lateral condyle BMD ratios, and visual analog scale (VAS) pain in both the femur and the tibia were higher in the obliteration group compared with the narrowing group (P < 0.001 for all). A significant positive correlation was observed between the femoral and tibial condyles in the following parameters: medial condyle BMDs, lateral condyle BMDs, and medial versus lateral condyle BMD ratios (r ؍ 0.791-0.844). In both the femur and the tibia, medial versus lateral condyle BMD ratios had significant positive correlations with femorotibial angle, medial osteophytes, lateral osteophytes, medial JSN, and VAS pain, and had significant negative correlations with the Knee Society pain and function scores. Conclusion. Although this study was a cross-sectional study, the femoral and tibial medial versus lateral condyle BMD ratios increased with more severe knee pain and might be a potential marker for monitoring disease severity in women with symptomatic medial knee OA.
BackgroundUncemented fixation of components in joint arthroplasty is achieved primarily through de novo bone formation at the bone-implant interface and establishment of a biological and mechanical interlock. In order to enhance bone-implant integration osteoconductive coatings and the methods of application thereof are continuously being developed and applied to highly porous and roughened implant substrates. In this study the effects of an electrochemically-deposited dicalcium phosphate dihydrate (DCPD) coating of a porous substrate on implant osseointegration was assessed using a standard uncemented implant fixation model in sheep.MethodsPlasma sprayed titanium implants with and without a DCPD coating were inserted into defects drilled into the cancellous and cortical sites of the femur and tibia. Cancellous implants were inserted in a press-fit scenario whilst cortical implants were inserted in a line-to-line fit. Specimens were retrieved at 1, 2, 4, 8 and 12 weeks postoperatively. Interfacial shear-strength of the cortical sites was assessed using a push-out test, whilst bone ingrowth, ongrowth and remodelling were investigated using histologic and histomorphometric endpoints.ResultsDCPD coating significantly improved cancellous bone ingrowth at 4 weeks but had no significant effect on mechanical stability in cortical bone up to 12 weeks postoperatively. Whilst a significant reduction in cancellous bone ongrowth was observed from 4 to 12 weeks for the DCPD coating, no other statistically significant differences in ongrowth or ingrowth in either the cancellous or cortical sites were observed between TiPS and DCPD groups.ConclusionThe application of a DCPD coating to porous titanium substrates may improve the extent of cancellous bone ingrowth in the early postoperative phase following uncemented arthroplasty.
Varus inclination of the tibial plateau was significantly more severe in the femorotibial angle tertile 3 group, and in patients with lower BMD in the ipsilateral lower limb. Varus knee OA may result not only from cartilage loss but also from structural changes of the bone.
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