Grace H Lo1, Mehveen G Merchant2, Jeffrey B Driban3, Jeffrey Duryea4, Lori Lyn Price5, Charles B Eaton6, Timothy E McAlindon3. 1. Baylor College of Medicine and Houston VA Health Services Research & Development Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Medical Center, Houston, Texas. 2. Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada. 3. Tufts Medical Center, Boston, Massachusetts. 4. Brigham and Women's Hospital, Boston, Massachusetts. 5. Tufts Medical Center and Tufts University, Boston, Massachusetts. 6. Memorial Hospital of Rhode Island and Alpert Medical School of Brown University, Pawtucket, Rhode Island.
Abstract
OBJECTIVE: Static alignment influences knee loading and predicts osteoarthritis (OA) progression. Periarticular bone is important in dispersing forces across the knee, and there is substantial evidence for molecular crosstalk between cartilage and subchondral bone. The aim of this study was to evaluate the relationship between periarticular trabecular bone morphology and bone mineral density (BMD) and knee alignment in OA. METHODS: This was a cross-sectional analysis of participants in the Osteoarthritis Initiative Bone Ancillary Study. Dual x-ray absorptiometry (DXA) was performed to measure tibial periarticular bone mineral density (paBMD). Magnetic resonance imaging of knee trabecular bone was performed to calculate the apparent bone volume fraction (aBVF), apparent trabecular number (aTbN), apparent trabecular spacing (aTbSp), and apparent trabecular thickness (aTbTh). Static alignment was assessed by measuring the hip-knee-ankle (HKA) angle on long-limb films. RESULTS: The study group comprised 436 participants (mean ± SD age 65.4 ± 9.2 years, 46% female, mean ± SD body mass index 29.6 ± 4.6 kg/m2 ), 71% of whom had OA. Correlations between the HKA angle and medial:lateral paBMD, medial paBMD, aBVF, aTbN, aTbTh, and aTbSp were -0.63, -0.34, -0.29, -0.32, -0.22, and 0.30, respectively. More varus alignment was associated with higher medial:lateral paBMD, medial paBMD, aBVF, aTbN, aTbTh, and lower aTbSp. In OA knees, the results were more pronounced. In non-OA knees, the most consistent association was with medial:lateral paBMD. CONCLUSION: Static alignment was associated with medial:lateral paBMD in all knees and with medial paBMD and trabecular morphometry in OA knees only. Aberrant knee loading may lead to increased relative subchondral bone density, which is partly related to a higher aBVF and a greater number of thicker trabeculae with smaller intertrabecular spacing. Knee DXA may be a useful early biomarker of knee OA.
OBJECTIVE: Static alignment influences knee loading and predicts osteoarthritis (OA) progression. Periarticular bone is important in dispersing forces across the knee, and there is substantial evidence for molecular crosstalk between cartilage and subchondral bone. The aim of this study was to evaluate the relationship between periarticular trabecular bone morphology and bone mineral density (BMD) and knee alignment in OA. METHODS:This was a cross-sectional analysis of participants in the Osteoarthritis Initiative Bone Ancillary Study. Dual x-ray absorptiometry (DXA) was performed to measure tibial periarticular bone mineral density (paBMD). Magnetic resonance imaging of knee trabecular bone was performed to calculate the apparent bone volume fraction (aBVF), apparent trabecular number (aTbN), apparent trabecular spacing (aTbSp), and apparent trabecular thickness (aTbTh). Static alignment was assessed by measuring the hip-knee-ankle (HKA) angle on long-limb films. RESULTS:The study group comprised 436 participants (mean ± SD age 65.4 ± 9.2 years, 46% female, mean ± SD body mass index 29.6 ± 4.6 kg/m2 ), 71% of whom had OA. Correlations between the HKA angle and medial:lateral paBMD, medial paBMD, aBVF, aTbN, aTbTh, and aTbSp were -0.63, -0.34, -0.29, -0.32, -0.22, and 0.30, respectively. More varus alignment was associated with higher medial:lateral paBMD, medial paBMD, aBVF, aTbN, aTbTh, and lower aTbSp. In OA knees, the results were more pronounced. In non-OA knees, the most consistent association was with medial:lateral paBMD. CONCLUSION: Static alignment was associated with medial:lateral paBMD in all knees and with medial paBMD and trabecular morphometry in OA knees only. Aberrant knee loading may lead to increased relative subchondral bone density, which is partly related to a higher aBVF and a greater number of thicker trabeculae with smaller intertrabecular spacing. Knee DXA may be a useful early biomarker of knee OA.
Authors: G H Lo; A M Tassinari; J B Driban; L L Price; E Schneider; S Majumdar; T E McAlindon Journal: Osteoarthritis Cartilage Date: 2012-03-16 Impact factor: 6.576
Authors: Grace H Lo; David J Hunter; Yuqing Zhang; Christine E McLennan; Michael P Lavalley; Douglas P Kiel; Robert R McLean; Harry K Genant; Ali Guermazi; David T Felson Journal: Arthritis Rheum Date: 2005-09
Authors: Leena Sharma; Joan S Chmiel; Orit Almagor; David Felson; Ali Guermazi; Frank Roemer; Cora E Lewis; Neil Segal; James Torner; T Derek V Cooke; Jean Hietpas; John Lynch; Michael Nevitt Journal: Ann Rheum Dis Date: 2012-05-01 Impact factor: 19.103
Authors: G H Lo; Y Zhang; C McLennan; J Niu; D P Kiel; R R McLean; P Aliabadi; D T Felson; D J Hunter Journal: Osteoarthritis Cartilage Date: 2006-06-09 Impact factor: 6.576
Authors: Reva C Lawrence; David T Felson; Charles G Helmick; Lesley M Arnold; Hyon Choi; Richard A Deyo; Sherine Gabriel; Rosemarie Hirsch; Marc C Hochberg; Gene G Hunder; Joanne M Jordan; Jeffrey N Katz; Hilal Maradit Kremers; Frederick Wolfe Journal: Arthritis Rheum Date: 2008-01
Authors: David T Felson; Sara McLaughlin; Joyce Goggins; Michael P LaValley; M Elon Gale; Saara Totterman; Wei Li; Catherine Hill; Daniel Gale Journal: Ann Intern Med Date: 2003-09-02 Impact factor: 25.391