Differences in subchondral bone plate and cartilage thickness between women with anterior cruciate ligament reconstructions and uninjured controls

Bhatla, Jennifer L; Kroker, Andres; Manske, Sarah L.; Emery, Carolyn A.; Boyd, Steven K.

doi:10.1016/j.joca.2018.04.006

Cited by 29 publications

(22 citation statements)

References 45 publications

(68 reference statements)

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“…In the present study, we found that cartilage degeneration is significantly associated with more severe sclerosis changes in STB microarchitecture, which supports the theory of a subchondral bone-cartilage functional unit where the OA disease state could destroy the homeostatic relationship between them under abnormal knee loads. In addition, Bhatla et al [42] showed that subchondral bone changes may be indicative of early OA pathogenesis of post-traumatic knee injuries, and Chen et al [43] also showed that abnormal STB remodeling is earlier than that of cartilage change and may contribute to the early pathogenesis of T2D-associated knee OA. However, given the cross-sectional design of the present study, we cannot prove the sequence of occurrence and causality between cartilage and STB, which requires further research to investigate the role of STB in progression of OA.…”

Section: Discussionmentioning

confidence: 99%

Association between knee alignment, osteoarthritis disease severity, and subchondral trabecular bone microarchitecture in patients with knee osteoarthritis: a cross-sectional study

et al. 2020

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Background: Knee osteoarthritis (OA) is a common disabling disease involving the entire joint tissue, and its onset and progression are affected by many factors. However, the current number of studies investigating the relationship between subchondral trabecular bone (STB), knee alignment, and OA severity is limited. We aimed to investigate the variation in tibial plateau STB microarchitecture in end-stage knee OA patients and their association with knee alignment (hip-knee-ankle, HKA, angle) and OA severity. Methods: Seventy-one knee OA patients scheduled for total knee arthroplasty (TKA) underwent preoperative radiography to measure the HKA angle and Kellgren-Lawrence grade. Tibial plateaus collected from TKA were scanned using micro-computed tomography to analyze the STB microarchitecture. Histological sections were used to assess cartilage degeneration (OARSI score). Correlations between the HKA angle, OA severity (OARSI score, Kellgren-Lawrence grade), and STB microarchitecture were evaluated. Differences in STB microstructural parameters between varus and valgus alignment groups based on the HKA angle were examined. Results: The HKA angle was significantly correlated with all STB microarchitecture parameters (p < 0.01). The HKA angle was more correlated with the medial-to-lateral ratios of the microarchitecture parameters than with the medial or lateral tibia plateaus. The HKA angle and all STB microarchitecture parameters are significantly correlated with both the OARSI score and Kellgren-Lawrence grade (p < 0.01). Conclusions: The STB microarchitecture is associated with the HKA angle and OA severity. With the increase of the knee alignment deviation and OA severity, the STB of the affected side tibial plateau increased in bone volume, trabecular number, and trabecular thickness and decreased in trabecular separation.

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Section: Discussionmentioning

confidence: 99%

Association between knee alignment, osteoarthritis disease severity, and subchondral trabecular bone microarchitecture in patients with knee osteoarthritis: a cross-sectional study

et al. 2020

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“…Previous studies have reported a higher average Tb.N and Tb.Th, which contributed to sclerotic changes in subchondral bone of advanced OA . In fact, the hypothesis that changes in subchondral bone might affect OA development is commonly acknowledged . Radin and Rose had originally proposed that densification of subchondral bone might lead to increased stiffness, thereby introducing adverse stress concentrations and sequential damage to articular cartilage.…”

Section: Discussionmentioning

confidence: 99%

“…(5)(6)(7) In fact, the hypothesis that changes in subchondral bone might affect OA development is commonly acknowledged. (4,9,(33)(34)(35)(36) Radin and Rose (37) had originally proposed that densification of subchondral bone might lead to increased stiffness, thereby introducing adverse stress concentrations and sequential damage to articular cartilage. Clinically, OP is another recognized factor that causes subchondral bone alterations in the functional unit of cartilage and subchondral bone.…”

Section: Discussionmentioning

confidence: 99%

Articular Cartilage Degradation and Aberrant Subchondral Bone Remodeling in Patients with Osteoarthritis and Osteoporosis

Chu

Liu

et al. 2019

Journal of Bone and Mineral Research

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Osteoarthritis (OA) and osteoporosis (OP) are two skeletal disorders associated with joint structures. Occasionally, OA and OP occur in the same patient. However, the effect of OP changes on OA progression in patients with osteoporotic OA (OP‐OA) has not been reported, especially the potential association between subchondral bone and articular cartilage. Thus we investigated the alterations in the microstructure, biomechanical properties, and remodeling of subchondral bone as well as their association with cartilage damage in the hip joint of patients with OP‐OA. Thirty‐nine femoral head specimens were obtained from patients who underwent total hip arthroplasty (OA group, n = 19; OP‐OA group, n = 20), and healthy specimens from cadaver donors were used (control group, n = 10). The microstructure and biomechanical properties of subchondral bone were evaluated by micro–computed tomography and micro–finite‐element analysis. Histology, histomorphometric measurements, and immunohistochemistry were used to assess subchondral bone remodeling and cartilage damage. Linear regression analysis was performed to elucidate the relationship between subchondral bone and articular cartilage. In the subchondral bone of the OP‐OA group, compared with that of the OA group, aberrant bone remodeling leads to an inferior microstructure and worsening biomechanical properties, potentially affecting transmission of loading stress from the cartilage to the subchondral bone, and then resulting in accelerated OA progression in patients with OP‐OA. The results indicate that changes in subchondral bone could affect OA development and the improvement in subchondral bone with bone‐metabolism agents may help mitigate OA progression when OP and OA coexist in the same patients. © 2019 American Society for Bone and Mineral Research.

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“…Many different approaches have been used to analyze cartilage thickness maps and our approach was based on a two‐step process. First data from the matched control subjects with normal knees were used to determine the side‐to‐side thickness differences and corresponding 95% confidence limits (i.e., normal thickness maps) at each 1 ×1 mm grid location.…”

Section: Discussionmentioning

confidence: 99%

“…If future work supports this hypothesis, our finding of a twofold increase in slope for the combined ACL-LM group in comparison to the isolated ACL group may provide a biomechanical explanation for why the risk of PTOA is greater for those that suffer combined injuries to the ACL and meniscus in comparison to those that suffer isolated ACL trauma. Many different approaches have been used to analyze cartilage thickness maps 9,11,[28][29][30][31][32][33] and our approach was based on a two-step process. First data from the matched control subjects with normal knees were used to determine the side-to-side thickness differences and corresponding 95% confidence limits (i.e., normal thickness maps) at each 1 ×1 mm grid location.…”

mentioning

confidence: 99%

Combined Injury to the ACL and Lateral Meniscus Alters the Geometry of Articular Cartilage and Meniscus Soon After Initial Trauma

Beynnon

Fiorentino

Gardner‐Morse

et al. 2019

Journal Orthopaedic Research

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Combined injury to the anterior cruciate ligament (ACL) and meniscus is associated with earlier onset and increased rates of post‐traumatic osteoarthritis compared with isolated ACL injury. However, little is known about the initial changes in joint structure associated with these different types of trauma. We hypothesized that trauma to the ACL and lateral meniscus has an immediate effect on morphometry of the articular cartilage and meniscus about the entire tibial plateau that is more pronounced than an ACL tear without meniscus injury. Subjects underwent magnetic resonance imaging scanning soon after injury and prior to surgery. Those that suffered injury to the ACL and lateral meniscus underwent changes in the lateral compartment (increases in the posterior–inferior directed slopes of the articular cartilage surface, and the wedge angle of the posterior horn of the meniscus) and medial compartment (the cartilage‐to‐bone height decreased in the region located under the posterior horn of the meniscus, and the thickness of cartilage increased and decreased in the mid and posterior regions of the plateau, respectively). Subjects that suffered an isolated ACL tear did not undergo the same magnitude of change to these articular structures. A majority of the changes in morphometry occurred in the lateral compartment of the knee; however, change in the medial compartment of the knee with a normal appearing meniscus also occurred. Statement of clinical significance: Knee injuries that involve combined trauma to the ACL and meniscus directly affect both compartments of the knee, even if the meniscus and articular cartilage appears normal upon arthroscopic examination. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 38:759‐767, 2020

show abstract

Differences in subchondral bone plate and cartilage thickness between women with anterior cruciate ligament reconstructions and uninjured controls

Cited by 29 publications

References 45 publications

Association between knee alignment, osteoarthritis disease severity, and subchondral trabecular bone microarchitecture in patients with knee osteoarthritis: a cross-sectional study

Association between knee alignment, osteoarthritis disease severity, and subchondral trabecular bone microarchitecture in patients with knee osteoarthritis: a cross-sectional study

Articular Cartilage Degradation and Aberrant Subchondral Bone Remodeling in Patients with Osteoarthritis and Osteoporosis

Combined Injury to the ACL and Lateral Meniscus Alters the Geometry of Articular Cartilage and Meniscus Soon After Initial Trauma

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