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

Abstract

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.

3D profiling of mouse epiphyses across ages reveals new potential imaging biomarkers of early spontaneous osteoarthritis

“…Contrastingly, Patel et al ( 2003 ) found lower trabecular BV/TV and thickness in small cores of the proximal human tibial plateau in OA. Such changes may have functional impact as trabecular bone is believed to serve as an impact‐dampener within load‐bearing joints (Seeman, 2008 ), and it is also responsive to local stresses (Reznikov et al, 2020 ), as evidenced by the differing medial and lateral trabecular organisation in valgus versus varus OA and non‐OA subjects (Rapagna et al, 2021 ; Renault et al, 2020 ; Roberts et al, 2017 ).…”

“…Subchondral bone evaluation typically involves selection of cubic or cylindrical core volumes of interest (VOIs) to measure 3D parameters (Cox et al, 2012 ; Finnila et al, 2017 ; Florea et al, 2015 ; Renault et al, 2020 ). This enables the rapid sampling without requisite segmentation of trabecular bone from the cortex and marrow space.…”

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

“…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.…”

Pathological, Morphometric and Correlation Analysis of the Modified Mankin Score, Tidemark Roughness and Calcified Cartilage Thickness in Rat Knee Osteoarthritis after Extracorporeal Shockwave Therapy

“…In this study, when the knees of animal received artificial induction of OA by ACL and medial menisectomy, they experienced the unbalance of mechanical loading stress by meniscal destabilization. Eventually, the medial tibia articular regions could develop severe coronal and trabecular mal-alignments, which were considered as the key factor for OA initiation [46][47][48][49]. Therefore, we theorized that ESWT application on medial tibia subchondral bone in early OA stage could triggered the appropriate tissue repair factors, such as BMPs, Wnt and VEGF and that might eventually alleviated OA progression [50].…”