Three‐dimensional mapping of the joint space for the diagnosis of knee osteoarthritis based on high resolution computed tomography: Comparison with radiographic, outerbridge, and meniscal classifications

Abstract

One of the most important characteristic of knee osteoarthritis (OA) is the joint space (JS) width narrowing. Measurements are usually performed on two dimensional (2D) X‐rays. We propose and validate a new method to assess the 3D joint space at the medial knee compartment using high resolution peripheral computed tomography images. A semi‐automated method was developed to obtain a distance 3D map between femur an tibia with the following parameters: volume, minimum, maximum, mean, standard deviation, median, asymmetry, and entropy. We analyzed 71 knee specimens (mean age: 85 years), radiographs were performed for the Kellgren Lawrence (KL) score grading. In a subgroup of 41 specimens, the histopathological Outerbridge and meniscal classifications were performed and then cores were harvested from the tibial plateau in three different positions (posterior, central, and peripheral) and imaged at 10 µm of resolution to measure the cartilage thickness. Minimum, maximum, mean, and median were statistically lower and entropy higher between knee specimens classified as KL = 0 and KL = 3–4. Gr1 and 2 were statistically different from Gr3‐4 for minimum, asymmetry, entropy using the Outerbridge classification and Gr1 was statistically different from Gr3–4 using the meniscal classification. Asymmetry, minimum, mean, median and entropy were significantly correlated with cartilage thickness. Parameters extracted from a 3D map of the medial joint space indicate local variations of JS and are related to local measurements of tibial cartilage thickness, and could be consequently useful to identify early OA. © 2018 The Authors. Journal of Orthopaedic Research® Published by Wiley Periodicals, Inc. on behalf of Orthopaedic Research Society. J Orthop Res 36:2380–2391, 2018.

Lateral Knee Osteoarthritis

“…[20,21] Computerized axial tomography has very specific indications in patients with lateral knee osteoarthritis and its use is reserved for evaluating bone anatomy in surgical planning. [22,23] Treatment methods for patients with lateral knee osteoarthritis are similar to those of the rest of the compartments; however patients tolerate nonoperative treatment better than those with medial compartment involvement. [24,25]…”

The Importance of the Knee Joint Meniscal Fibrocartilages as Stabilizing Weight Bearing Structures Providing Global Protection to Human Knee-Joint Tissues

“…Phase-contrast μCT is an emerging imaging technique, which is able to resolve 3D micro-scale structures in tissue samples without the need for staining or sectioning but also complements conventional histology providing additional information on the fine structure of meniscal tissues. 3D-mapping of the joint space for the diagnosis of knee OA using high resolution computed tomography has compared radiographic, normal and degenerate meniscal pathology [31]. Bioluminescence and second harmonic generation imaging reveal dynamic changes in the inflammatory and collagen landscape in early OA [32].…”

“…Many reviews have emphasized the great potential of MSCs for meniscal repair applications [25,31,36,40,42,43,45,71]. MSCs have been employed in numerous strategies aimed to promote repair of meniscal lacerations [23] and defects in the avascular inner meniscal zone [39,89,90,91] or in meniscal replacement in meniscectomised animals [83].…”

“…Three-dimensional coculture of meniscal cells and MSCs in collagen Type I hydrogels have also demonstrated positive responses in terms of matrix production conducive to meniscal repair processes [107]. Evaluation of effects on cell shape, matrix production, and mechanical performance of neo-tissues produced by such 3D MSC: meniscal cell co-cultures has shown positive effects of potential application in the repair of meniscal defects [31,108]. Direct cell-cell contact between MSCs and meniscal cells is not required to elicit such positive responses since MSC conditioned media can elicit similar responses in meniscal cells due to trophic factors transferred from the MSCs by paracrine effects.…”

Quantification of Cartilage Surface Degeneration by Curvature Analysis Using 3D Scanning in a Rabbit Model

“…1 The main gross morphologic characteristics are narrowing of the joint space width, sclerosis of the subchondral bone, and the presence of osteophytes. 2 Epidemiological and genetic studies of OA showed that many pre-OA disease statuses can be improved. 3 However, early diagnosis and treatment of OA is still a challenge due to the complexity and length of the disease process that is influenced by mechanical, biological, and structural factors.…”