Abstract
Osteoarthritis (OA) is the most common type of arthritis and a major cause of disability in the adult population. It affects both cartilage and subchondral bone in the joints. There has been some progress in understanding the changes in subchondral bone with progression of osteoarthritis. However, local changes in subchondral bone such as microstructure or volumetric bone mineral density 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 volumetric bone mineral density (vBMD) distribution in the osteoarthritic joint tissues obtained from total hip replacement surgeries due to osteoarthritis, using peripheral quantitative CT (pQCT). It was found that there is a significant decrease in volumetric bone mineral density, which co-localises 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 volumetric bone mineral density 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.
Highlights
Osteoarthritis (OA) is a degenerative joint disease, characterized by degradation of cartilage and changes in the subchondral bone
We investigated the effects of cartilage degeneration in the OA joints on subchondral volumetric bone mineral density (vBMD) both locally and distantly to the overlying cartilage, as well as the association of vBMD in OA subchondral bone with the degree of damage in the articular cartilage as assessed through peripheral quantitative CT (pQCT)
This may show the potential of using pQCT for detection of early OA based on changes in vBMD; based on our results, with progression of OA, for example from grade I to grade II, a significant decrease is detectable by pQCT
Summary
Osteoarthritis (OA) is a degenerative joint disease, characterized by degradation of cartilage and changes in the subchondral bone. Patients with OA often suffer from pain, loss of mobility, and go on to require an end-stage total joint replacement. In 2015, 215,502 joint replacements were performed in England and Wales predominantly for OA (93%) (National Joint Registry for England, 2015). According to the World Health Organisation, 52% of people over 70 years old have OA. It affects around 400 million people’s lives, and this number will increase with an increasing aging population (Goldring and Goldring, 2010, Litwic et al, 2013).
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