Decrease in Local Volumetric Bone Mineral Density in Osteoarthritic Joints Is Associated with the Increase in Cartilage Damage: A Peripheral Quantitative CT Study

Abstract

Osteoarthritis (OA) is one of the most prevalent joint diseases, which causes pain and disability in the adult population. OA affects the osteochondral unit in the joints, which comprises both cartilage and subchondral bone. There has been some progress in understanding the changes in subchondral bone with progression of OA. However, local changes in subchondral bone such as microstructure or volumetric bone mineral density (vBMD) in connection with the defect in cartilage are relatively unexplored. To develop an effective treatment for progression of OA, it is important to understand how the physical environment provided by the subchondral bone affects the overlying cartilage. In this study, we examined the vBMD distribution in the OA joint tissues obtained from total hip replacement surgeries due to OA, using peripheral quantitative CT (pQCT). It was found that there is a significant decrease in vBMD, which co-localizes with the damage in the overlying cartilage. This was not limited to the subchondral bone immediately adjacent to the cartilage defect but continued in the layers below. Bone resorption and cyst formation in the OA tissues were also detected. We observed that the bone surrounding subchondral bone cysts exhibited much higher vBMD than that of the surrounding bones. pQCT was able to detect significant changes in vBMD between OA and non-OA samples, as well as between areas of different cartilage degeneration, which points to its potential as a technique for detection of early OA.

A new approach to comprehensively evaluate the morphological properties of the human femoral head: example of application to osteoarthritic joint

“…Several studies have reported subchondral bone plate (SBP) thinning and loss of subchondral trabecular bone (STB) in early OA [9][10][11][12] , with some suggestions that subchondral bone changes may precede changes in cartilage 13,14 . However, the hallmark features of end-stage OA comprise a thickening of the SBP 12,15,16 , together with increased bone volume fraction, increased trabecular thickness, and decreased trabecular separation in the STB [17][18][19][20] , lower bone mineralisation 21,22 and the presence of subchondral bone cysts (SBCs), and osteophytosis 23 . The aforementioned studies highlight overall trends in subchondral bone changes, but these studies have been primarily restricted to excised bone specimen cores, in most cases taken along the main loading axis of the bone.…”

“…A limited number of studies have performed spatial analyses on bone within the human femoral head 26 . Using peripheral quantitative computed tomography (pQCT), Tamaddon, et al 22 performed a mapping of volumetric bone mineral density (vBMD) over 36 regions, relative to the region of greatest cartilage damage; reporting a decrease in vBMD immediately adjacent to overlying cartilage defects, which continued deep into the bone, but an increase in vBMD in the bone surrounding SBP. While this approach showed heterogeneous vBMD across the femoral head, nothing is known about the heterogeneity of micro-architectural parameters in the cortical and trabecular bone, considered by some the main determinants of bone quality 27 .…”

Spatial links between subchondral bone architectural features and cartilage degeneration in osteoarthritic joints

“…Previous studies in OA hips report thicker trabeculae, higher trabecular number and increased bone volume fraction at late OA compared to early-stage OA or normal hips 13 , 20 – 22 . Whilst these studies have significantly enhanced understanding of bone structural changes during OA development, the reported measures are based on defined segments/biopsies extracted from the femoral head 13 , 23 – 25 .…”

Oxygen and Glucose Transportation and Distribution on 3D Osteochondral Scaffold in Silico Model

“…In the tissue engineering field, scaffolds act as a 3D structure for supporting cell growth, providing sufficient mechanical support and provide an extracellular matrix environment for tissue regeneration [1][2][3][4][5]. To achieve success in tissue engineering, nutrient transports into the interior scaffold should be well investigated as it is one of the most significant factors in the success for a scaffold [6,7].…”