Reduced tissue hardness of trabecular bone is associated with severe osteoarthritis

Dall’Ara, Enrico; Öhman, Caroline; Baleani, Massimiliano; Viceconti, Marco

doi:10.1016/j.jbiomech.2010.12.022

Cited by 36 publications

(19 citation statements)

References 37 publications

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“…The conflicting findings may be related to differences in sample processing and indentation testing conditions (e.g., maximum load, load/unload rate, load holding time, sites of bone collection, and indentation depth and area) (42–44). Taken together, our findings and the results from other studies (39, 42, 45) lead us to postulate that in OA cancellous bone, the degree of mineralization is slightly decreased as compared with normal or OP cancellous bone, but the change in bone hardness is uncertain.…”

Section: Discussionsupporting

confidence: 72%

Difference in subchondral cancellous bone between postmenopausal women with hip osteoarthritis and osteoporotic fracture: Implication for fatigue microdamage, bone microarchitecture, and biomechanical properties

Dai²,

Jiang

et al. 2012

Arthritis & Rheumatism

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Objective. Osteoarthritis (OA) and osteoporosis (OP) of the hip rarely occur in the same patient. The purpose of this study was to determine whether this difference might be attributable to the different quantity and quality of subchondral cancellous bone in the two conditions.Methods. Subchondral cancellous bone from the femoral head was obtained at the time of hip arthroplasty from 60 postmenopausal women, 30 with OA and 30 with OP. In each group, 10 specimens were subjected to compressive fatigue loading and 20 were left nonloaded. Specimens were examined by compressive mechanical testing, micro-computed tomography scanning, fluorescence microscopy, and nanoindentation techniques.Results. Both the ultimate stress and the elastic modulus of cancellous bone from OA patients were significantly higher than those of cancellous bone from OP patients (P < 0.05). Compared to cancellous bone from OP patients, the bone volume fraction and trabecular thickness were significantly increased, but bone matrix mineralization was significantly decreased, in cancellous bone from OA patients (P < 0.05 for each comparison). The microcrack density was significantly higher in OP cancellous bone than in OA cancellous bone (P < 0.001), irrespective of fatigue loading. In addition, fatigue loading resulted in a significant increase in microcrack density in both OA and OP cancellous bone (P < 0.001). There was no significant difference in nanoindentation elastic modulus and hardness between cancellous bone from OA and OP patients, as well as between bones with and without fatigue loading.Conclusion. The difference in mechanical properties between OA and OP cancellous bone is attributed to different bone mass and bone structure. OP cancellous bone is susceptible to fatigue damage due to insufficient structure. However, increased bone volume and platelike structure provide OA cancellous bone a superior capacity to resist fatigue damage.Osteoarthritis (OA) and osteoporosis (OP) are two orthopedic disorders that usually result in high rates of morbidity and disability in people over the age of 50 years, particularly in postmenopausal women (1,2). Although OA and OP commonly occur in the elderly, they rarely coexist in a single patient (1,3). Healey et al (4) reported that only 4% of OP patients had significant osteoarthritis in the hip. It is well known that OP is associated with bone loss and microstructure deterioration, which can reduce bone strength and thereby increase the risk of fragility fracture (5). In contrast, the pathogenesis of OA remains a subject of controversy (6,7). In general, OA initially presents with destruction

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Section: Discussionsupporting

confidence: 72%

Difference in subchondral cancellous bone between postmenopausal women with hip osteoarthritis and osteoporotic fracture: Implication for fatigue microdamage, bone microarchitecture, and biomechanical properties

Dai²,

Jiang

et al. 2012

Arthritis & Rheumatism

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“…*email: jean-baptiste.renault@univ-amu.fr open material 14,23 . The material alterations observed are consistent with the observed lower mechanical properties at microscale, as quantified by nanoindentation 24,25 .…”

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confidence: 85%

Tibial subchondral trabecular bone micromechanical and microarchitectural properties are affected by alignment and osteoarthritis stage

Renault

Carmona

Tzioupis

et al. 2020

Sci Rep

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At advanced knee osteoarthritis (OA) stages subchondral trabecular bone (STB) is altered. Lower limb alignment plays a role in OA progression and modify the macroscopic loading of the medial and lateral condyles of the tibial plateau. How the properties of the STB relate to alignment and OA stage is not well defined. OA stage (KL scores 2-4) and alignment (HKA from 17° Varus to 8° Valgus) of 30 patients were measured and their tibial plateau were collected after total knee arthroplasty. STB tissue elastic modulus, bone volume fraction (BV/TV) and trabecula thickness (Tb.Th) were evaluated with nanoindentation and µCT scans (8.1 µm voxel-size) of medial and lateral samples of each plateau. HKA and KL scores were statistically significantly associated with STB elastic modulus, BV/TV and Tb.Th. Medial to lateral BV/TV ratio correlated with HKA angle (R = −0.53, p = 0.016), revealing a higher ratio for varus than valgus subjects. STB properties showed lower values for KL stage 4 patients. Tissue elastic modulus ratios and BV.TV ratios were strongly correlated (R = 0.81, p < 0.001). Results showed that both micromechanical and microarchitectural properties of STB are affected by macroscopic loading at late stage knee OA. For the first time, a strong association between tissue stiffness and quantity of OA STB was demonstrated.

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“…An increased trabecular number, decreased trabecular spacing, and reduced hardness of the bone in OA [ 22 ], due to decreased mineralization [ 23 ], characterize the subchondral bone, especially in zones underlying cartilage degeneration. Discrete zones of subchondral bone that can be imaged using magnetic resonance (MR), termed bone marrow lesions (BML), are frequently observed in both established OA and in early OA, but rarely in symptom free individuals [ 24 , 25 ].…”

Section: Osteoblasts In Oamentioning

confidence: 99%

Osteoblast-Chondrocyte Interactions in Osteoarthritis

Findlay

Atkins

2014

Curr Osteoporos Rep

127

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There is now general agreement that osteoarthritis (OA) involves all structures in the affected joint, culminating in the degradation of the articular cartilage. It is appropriate to focus particularly on the subchondral bone because characteristic changes occur in this tissue with disease progression, either in parallel, or contributing to, the loss of cartilage volume and quality. Changes in both the articular cartilage and the subchondral bone are mediated by the cells in these two compartments, chondrocytes and cells of the osteoblast lineage, respectively, whose primary roles are to maintain the integrity and function of these tissues. In addition, altered rates of bone remodeling across the disease process are due to increased or decreased osteoclastic bone resorption. In the altered mechanical and biochemical environment of a progressively diseased joint, the cells function differently and show a different profile of gene expression, suggesting direct effects of these external influences. There is also ex vivo and in vitro evidence of chemical crosstalk between the cells in cartilage and subchondral bone, suggesting an interdependence of events in the two compartments and therefore indirect effects of, for example, altered loading of the joint. It is ultimately these cellular changes that explain the altered morphology of the cartilage and subchondral bone. With respect to crosstalk between the cells in cartilage and bone, there is evidence that small molecules can transit between these tissues. For larger molecules, such as inflammatory mediators, this is an intriguing possibility but remains to be demonstrated. The cellular changes during the progression of OA almost certainly need to be considered in a temporal and spatial manner, since it is important when and where observations are made in either human disease or animal models of OA. Until recently, comparisons have been made with the assumption, for example, that the subchondral bone is behaviorally uniform, but this is not the case in OA, where regional differences of the bone are evident using magnetic resonance imaging (MRI). Nevertheless, an appreciation of the altered cell function during the progression of OA will identify new disease modifying targets. If, indeed, the cartilage and subchondral bone behave as an interconnected functional unit, normalization of cell behavior in one compartment may have benefits in both tissues.

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Reduced tissue hardness of trabecular bone is associated with severe osteoarthritis

Cited by 36 publications

References 37 publications

Difference in subchondral cancellous bone between postmenopausal women with hip osteoarthritis and osteoporotic fracture: Implication for fatigue microdamage, bone microarchitecture, and biomechanical properties

Difference in subchondral cancellous bone between postmenopausal women with hip osteoarthritis and osteoporotic fracture: Implication for fatigue microdamage, bone microarchitecture, and biomechanical properties

Tibial subchondral trabecular bone micromechanical and microarchitectural properties are affected by alignment and osteoarthritis stage

Osteoblast-Chondrocyte Interactions in Osteoarthritis

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