Trabecular orientation in the human femur and tibia and the relationship with lower-limb alignment for patients with osteoarthritis of the knee

Abstract

Wolff׳s Law suggests that the orientation of trabeculae in human bone changes in response to altered loading patterns. The aim of this study was to investigate trabecular orientation in both the femur and tibia and to compare this with the mechanical axis of the leg. The study involved analysis of radiographs from patients with osteoarthritis of the knee (n=91). For each patient, the trabecular orientation in both the distal femur and proximal tibia was measured from a standard anteroposterior radiograph of the knee and the mechanical axis of the leg was calculated from a long leg view taken while weight bearing. There was a significant correlation between the mechanical axis and the trabecular orientation in each of the regions considered in the femur (r=-0.41, -0.30, 0.52, and 0.23) and tibia (r=-0.27 and 0.31). Multiple regression analysis, with mechanical axis as the dependent variable, produced an R(2) of 0.62. Greater trabecular anisotropy (i.e. greater alignment) was observed in the medial femur and tibia compared to the lateral side (p<0.01). The results give an insight into the trabecular changes that may take place during development of osteoarthritis and following surgery. In particular, we propose that the orientation of the trabeculae in both the distal femur and proximal tibia will reflect the angle of mechanical loading through the knee.

Trabecular bone texture analysis of conventional radiographs in the assessment of knee osteoarthritis: review and viewpoint

“…To the best of our knowledge, the ability of these microarchitectural changes, detected about 4 years after injury, to predict the ongoing incidence of PTOA has not yet been evaluated. The trabecular orientation in the distal and proximal tibia was investigated by Sampath et al [ 34 ], considering 90 OA patients, mostly with varus alignment. Significant correlations between the mechanical axis (leg alignment), calculated as the angle between the femoral and tibial axes, and trabecular orientation, determined using structure tensor-based analysis, in both distal and proximal tibia, were observed.…”

Spatial mapping of collagen content and structure in human intervertebral disk degeneration

“…38 It has been used extensively to quantify collagen orientation and disorder. 39,42,43 Quantifying research suggested a shift from type II collagen to type I collagen content as the NP degenerates, 13,18,19 with a concurrent decrease in total collagen content. 18,44 The loss in total collagen stands in contrast to the notable morphological shift from gelatinous to fibrous that is often described in the literature.…”

“…We utilized OrientationJ in our morphometric analysis, a plugin based on structure tensors that evaluates the local orientation and isotropic properties (orientation, coherency, and energy) of every pixel in the image 38 . It has been used extensively to quantify collagen orientation and disorder 39,42,43 . Quantifying the entropy of the resulting orientation map provides a measure of the complexity of collagen orientations in the imaged structure.…”

A Novel Technique for Varus Tibial Cutting for Oxford Unicompartmental Knee Arthroplasty

“…Varus implantation can also be beneficial for load transmission because the joint line can be made parallel to the floor. 4) Sampath et al 9) showed that the trabecular orientation could be changed according to the leg alignment and direction of the load across the joint. Implantation of the tibial tray in the same orientation might be best supported by the underlying trabecular.…”