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Relationships between in vivo dynamic knee joint loading, static alignment and tibial subchondral bone microarchitecture in end-stage knee osteoarthritis
被引：34
作者：
Roberts, B. C.
[1
]
Solomon, L. B.
[2
,3
]
Mercer, G.
[4
]
Reynolds, K. J.
[1
]
Thewlis, D.
[2
,3
,5
]
Perilli, E.
[1
]
机构：
[1] Flinders Univ S Australia, Coll Sci & Engn, Med Device Res Inst, GPO Box 2100, Adelaide, SA 5001, Australia
[2] Royal Adelaide Hosp, Dept Orthopaed & Trauma, Adelaide, SA, Australia
[3] Univ Adelaide, Ctr Orthopaed & Trauma Res, Adelaide, SA, Australia
[4] Repatriat Gen Hosp, Dept Orthopaed Surg, Daw Pk, SA, Australia
[5] Univ South Australia, Sansom Inst Hlth Res, Alliance Res Exercise Nutr & Act, Adelaide, SA, Australia
基金：
澳大利亚国家健康与医学研究理事会;
英国医学研究理事会;
关键词：
Knee osteoarthritis;
Gait biomechanics;
Micro-CT;
Subchondral trabecular bone;
Bone microarchitecture;
MINERAL DENSITY;
DISEASE PROGRESSION;
CANCELLOUS BONE;
TRABECULAR BONE;
GAIT;
CARTILAGE;
WALKING;
INDIVIDUALS;
MOMENTS;
PARAMETERS;
D O I：
10.1016/j.joca.2018.01.014
中图分类号：
R826.8 [整形外科学];
R782.2 [口腔颌面部整形外科学];
R726.2 [小儿整形外科学];
R62 [整形外科学（修复外科学）];
学科分类号：
摘要：
Objective: To study, in end-stage knee osteoarthritis (OA) patients, relationships between indices of in vivo dynamic knee joint loads obtained pre-operatively using gait analysis, static knee alignment, and the subchondral trabecular bone (STB) microarchitecture of their excised tibial plateau quantified with 3D micro-CT. Design: Twenty-five knee OA patients scheduled for total knee arthroplasty underwent pre-operative gait analysis. Mechanical axis deviation (MAD) was determined radiographically. Following surgery, excised tibial plateaus were micro-CT-scanned and STB microarchitecture analysed in four subregions (anteromedial, posteromedial, anterolateral, posterolateral). Regional differences in STB microarchitecture and relationships between joint loading and microarchitecture were examined. Results: STB microarchitecture differed among subregions (P < 0.001), anteromedially exhibiting highest bone volume fraction (BV/TV) and lowest structure model index (SMI). Anteromedial BV/TV and SMI correlated strongest with the peak external rotation moment (ERM; r = -0.74, r = 0.67, P < 0.01), despite ERM being the lowest (by factor of 10) of the moments considered, with majority of ERM measures below accuracy thresholds; medial-to-lateral BV/TV ratios correlated with ERM, MAD, knee adduction moment (KAM) and internal rotation moment (vertical bar r vertical bar-range: 0.54-0.74). When controlling for walking speed, KAM and MAD, the ERM explained additional 11-30% of the variations in anteromedial BV/TV and medial-to-lateral BV/TV ratio (R-2 = 0.59, R-2 = 0.69, P < 0.01). Conclusions: This preliminary study suggests significant associations between tibial plateau STB microarchitecture and knee joint loading indices in end-stage knee OA patients. Particularly, anteromedial BV/TV correlates strongest with ERM, whereas medial-to-lateral BV/TV ratio correlates strongest with indicators of medial-to-lateral joint loading (MAD, KAM) and rotational moments. However, associations with ERM should be interpreted with caution. (C) 2018 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.
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页码：547 / 556
页数：10
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