Cartilage calcification of the ankle joint is associated with osteoarthritis in the general population

Jan Hubert,Klaus Püschel,Thelonius Hawellek,Wolfgang Lehmann,Annemarie Uhlig,Tim Rolvien,Sebastian Karl Butscheidt,Sandra Hischke,Lukas Weiser,Tobias Schmidt,Frank Timo Beil

doi:10.1186/s12891-018-2094-7

Abstract

BackgroundCartilage calcification (CC) is associated with osteoarthritis (OA) in weight-bearing joints, such as the hip and the knee. However, little is known about the impact of CC and degeneration on other weight-bearing joints, especially as it relates to the occurrence of OA in the ankles. The goal of this study is to analyse the prevalence of ankle joint cartilage calcification (AJ CC) and to determine its correlation with factors such as histological OA grade, age and BMI in the general population.MethodsCC of the distal tibia and talus in 160 ankle joints obtained from 80 donors (mean age 62.4 years, 34 females, 46 males) was qualitatively and quantitatively analysed using high-resolution digital contact radiography (DCR). Correlations with factors, such as the joint’s histological OA grade (OARSI score), donor’s age and BMI, were investigated.ResultsThe prevalence of AJ CC was 51.3% (95% CI [0.40, 0.63]), independent of gender (p = 0.18) and/or the joint’s side (p = 0.82). CC of the distal tibia was detected in 35.0% (28/80) (95% CI [0.25, 0.47]) and talar CC in 47.5% (38/80) (95% CI [0.36, 0.59]) of all cases. Significant correlations were noted between the mean amount of tibial and talar CC (r = 0.59, p = 0.002), as well as between the mean amount of CC observed in one ankle joint with that of the contralateral side (r = 0.52, p = 0.02). Furthermore, although the amount of AJ CC observed in the distal tibia and talus correlated with the histological OA-grade of the joint (r = 0.70, p < 0.001 and r = 0.72, p < 0.001, respectively), no such correlation was seen in the general population with relation to age (p = 0.32 and p = 0.49) or BMI (p = 0.51 and p = 0.87).ConclusionThe prevalence of AJ CC in the general population is much higher than expected. The relationship between the amount of AJ CC and OA, independent of the donors’ age and BMI, indicates that CC may play a causative role in the development of OA in ankles.

Highlights

Cartilage calcification (CC) is associated with osteoarthritis (OA) in weight-bearing joints, such as the hip and the knee
Intraindividual correlations existed between the amount of CC of the left with that of the right ankle joint (AJ), as well as between the distal tibial and the talar cartilage
Since calcification has already been found in intact AJ cartilage and the amount of CC correlated with the histological OA grade, we hypothesize that CC may play a causative role in the pathogenesis of AJ OA

Summary

Introduction

Cartilage calcification (CC) is associated with osteoarthritis (OA) in weight-bearing joints, such as the hip and the knee. The goal of this study is to analyse the prevalence of ankle joint cartilage calcification (AJ CC) and to determine its correlation with factors such as histological OA grade, age and BMI in the general population. While OA in weight-bearing hip and knee joints is relatively common, in the ankle joint (AJ) it affects only 1% of the population [2]. Eckstein et al reported surprisingly high variability in the quantitative distribution of cartilage in the ankles of patients [6], whereas Quinn et al found intraindividual variations in the cartilage cells and matrix morphologies of knees and ankle joints [7]

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