In vivo analysis of subchondral trabecular bone in patients with osteoarthritis of the knee using second-generation high-resolution peripheral quantitative computed tomography (HR-pQCT)

Shiraishi, Kazunori; Chiba, Ko; Okazaki, Narihiro; Yokota, Kazuaki; Nakazoe, Yusuke; Kidera, Kenichi; Yonekura, Akihiko; Tomita, Masato; Osaki, Makoto

doi:10.1016/j.bone.2019.115155

Cited by 23 publications

(16 citation statements)

References 46 publications

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“…Knee joint malalignment has previously been linked to altered medial-to-lateral distribution of loads upon the joint 10,11 and has been associated with regional changes in either subchondral bone 10,[12][13][14][15][16] or cartilage 17,18 in OA. In our previous study, on mapping of the three-dimensional (3D) bone microarchitecture of end-stage knee OA tibial plateaus, 10 joint alignment was suggested to be related to medial-to-lateral and within-condylar bone microarchitecture differences in OA groups.…”

Section: Introductionmentioning

confidence: 99%

Tibial cartilage, subchondral bone plate and trabecular bone microarchitecture in varus‐ and valgus‐osteoarthritis versus controls

Rapagna

Roberts

Solomon

et al. 2020

Journal Orthopaedic Research

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This preliminary study quantified tibia cartilage thickness (Cart.Th), subchondral bone plate thickness (SBPl.Th) and subchondral trabecular bone (STB) microarchitecture in subjects with varus-or valgus-malaligned knees diagnosed with end-stage knee osteoarthritis (OA) and compared them to controls (non-OA). Tibial plateaus from 25 subjects with knee-OA (undergoing knee arthroplasty) and 15 cadavers (controls) were micro-CT scanned (17 µm/voxel). Joint alignment was classified radiographically for OA subjects (varus-aligned n = 18, valgus-aligned n = 7). Cart.Th, SBPl.Th, STB bone volume fraction (BV/TV) and their medial-tolateral ratios were analyzed in anteromedial, anterolateral, posteromedial and posterolateral subregions. Varus-OA and valgus-OA were compared to controls.Compared to controls (1.19-1.54 mm), Cart.Th in varus-OA was significantly lower anteromedially (0.58 mm, −59%) and higher laterally (2.19-2.47 mm, +60-63%); in valgus-OA, Cart.Th was significantly higher posteromedially (1.86 mm, +56%).Control medial-to-lateral Cart.Th ratios were around unity (0.8-1.1), in varus-OA significantly below (0.2-0.6) and in valgus-OA slightly above (1.0-1.3) controls.SBPl.Th and BV/TV were significantly higher medially in varus-OA (0.58-0.72 mm and 37-44%, respectively) and laterally in valgus-OA (0.60-0.61 mm and 32-37%), compared to controls (0.26-0.47 mm and 18-37%). In varus-OA, the medial-tolateral SBPl.Th and BV/TV ratios were above unity (1.4-2.4) and controls (0.8-2.1); in valgus-OA they were closer to unity (0.8-1.1) and below controls. Varus-and valgus-OA tibia differ significantly from controls in Cart.Th, SBPl.Th and STB microarchitecture depending on joint alignment, suggesting structural changes in OA may reflect differences in medial-to-lateral load distribution upon the tibial plateau. Here we identified an inverse relationship between cartilage thickness and underlying subchondral bone, suggesting a whole-joint response in OA to daily stimuli.

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Section: Introductionmentioning

confidence: 99%

Tibial cartilage, subchondral bone plate and trabecular bone microarchitecture in varus‐ and valgus‐osteoarthritis versus controls

Rapagna

Roberts

Solomon

et al. 2020

Journal Orthopaedic Research

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“…179,180 More recently, studies utilizing high-resolution peripheral quantitative computed tomography have identified microstructural changes in the subchondral bone of OA patients, also implicating abnormal bone remodeling as part of OA pathogenesis. 183,184 In particular, Chen et al 183 found there was a reduction in rod-like trabeculae and thickening of plate-like trabeculae in human and guinea pig OA knees, which preceded cartilage damage in the guinea pig OA model. Together these studies challenge the traditional view of OA as simply a degenerative cartilage disease, and suggest that OA also involves complex interactions between the underlying subchondral bone, which may occur prior to cartilage damage.…”

Section: Osteoarthritismentioning

confidence: 99%

Section: Osteoarthritismentioning

confidence: 99%

Arthritis and the role of endogenous glucocorticoids

2020

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Rheumatoid arthritis and osteoarthritis, the most common forms of arthritis, are chronic, painful, and disabling conditions. Although both diseases differ in etiology, they manifest in progressive joint destruction characterized by pathological changes in the articular cartilage, bone, and synovium. While the potent anti-inflammatory properties of therapeutic (i.e., exogenous) glucocorticoids have been heavily researched and are widely used in clinical practice, the role of endogenous glucocorticoids in arthritis susceptibility and disease progression remains poorly understood. Current evidence from mouse models suggests that local endogenous glucocorticoid signaling is upregulated by the pro-inflammatory microenvironment in rheumatoid arthritis and by aging-related mechanisms in osteoarthritis. Furthermore, these models indicate that endogenous glucocorticoid signaling in macrophages, mast cells, and chondrocytes has anti-inflammatory effects, while signaling in fibroblast-like synoviocytes, myocytes, osteoblasts, and osteocytes has pro-inflammatory actions in rheumatoid arthritis. Conversely, in osteoarthritis, endogenous glucocorticoid signaling in both osteoblasts and chondrocytes has destructive actions. Together these studies provide insights into the role of endogenous glucocorticoids in the pathogenesis of both inflammatory and degenerative joint disease.

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“…Subchondral bone thickening and sclerosis have been considered hallmarks of knee OA, (3,4) but the patterns of bone-quality abnormalities in knee OA are more complex. For example, Chen and colleagues (5) and Shiraishi and colleagues (6) have shown that although trabecular plate thickening is observed in the subchondral bone in OA, high-resolution peripheral quantitative computed tomography (QCT) also shows a loss of rods and compromised bone quality reminiscent of osteoporosis in progressive disease. There is therefore some evidence for compromised bone quality in knee OA similar to that of osteoporosis, although longitudinal studies are needed to track the pattern progression.…”

Section: To the Editormentioning

confidence: 99%

Response to: Challenges to the Possible Use of Bisphosphonates in Early-Stage Osteoarthritis

Hayes

Giannakeas

Wong

2020

Journal of Bone and Mineral Research

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In vivo analysis of subchondral trabecular bone in patients with osteoarthritis of the knee using second-generation high-resolution peripheral quantitative computed tomography (HR-pQCT)

Cited by 23 publications

References 46 publications

Tibial cartilage, subchondral bone plate and trabecular bone microarchitecture in varus‐ and valgus‐osteoarthritis versus controls

Tibial cartilage, subchondral bone plate and trabecular bone microarchitecture in varus‐ and valgus‐osteoarthritis versus controls

Arthritis and the role of endogenous glucocorticoids

Response to: Challenges to the Possible Use of Bisphosphonates in Early-Stage Osteoarthritis

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