Abstract
Bone is integral to the pathogenesis of osteoarthritis (OA). Whether the bone area of the tibial plateau changes over time in subjects with knee OA is unknown. We performed a cohort study to describe this and identify factors that might influence the change. One hundred and twenty-six subjects with knee OA underwent baseline knee radiography and magnetic resonance imaging on their symptomatic knee. They were followed up with a repeatmagnetic resonance image of the same knee approximately 2 years later. The bone area of the tibial plateau was measured at baseline and follow-up. Risk factors assessed at baseline were tested for their association with change in tibial plateau bone area over time. One hundred and seventeen subjects completed the study. The medial and lateral tibial plateau bone areas increased by 2.2 ± 6.9% and 1.5 ± 4.3% per year, respectively. Being male (P = 0.001), having a higher body mass index (P = 0.002), and having a higher baseline grade of medial joint-space narrowing (P = 0.01) were all independently and positively associated with an increased rate of enlargement of bone area of the medial tibial plateau. A larger baseline bone area of the medial tibial plateau was inversely associated with the rate of increase of that area (P < 0.001). No factor examined affected the rate of increase of the bone area of the lateral tibial plateau. In subjects with established knee OA, tibial plateau bone area increases over time. The role of subchondral bone change in the pathogenesis of knee OA will need to be determined but may be one explanation for the mechanism of action of risk factors such as body mass index on knee OA.
Highlights
Osteoarthritis (OA) is the most common form of joint disease, with a prevalence of 10 to 30% in persons over the age of 65 [1]
In subjects with established knee OA, tibial plateau bone area increases over time
Adjustment for WOMAC score and SF-36 score did not affect these results. In this 2-year longitudinal study, we found that there was a significant increase in tibial plateau bone area in symptomatic subjects with predominantly mild to moderate knee OA
Summary
Osteoarthritis (OA) is the most common form of joint disease, with a prevalence of 10 to 30% in persons over the age of 65 [1]. Changes in subchondral bone are well described in established OA, in human [3,4,5,6,7] as well as animal [8,9,10,11,12,13] models These changes include remodelling of the subchondral trabeculae [3,4,8,9,10,11], stiffening of the subchondral bone [5,12,13], thickening of the subchondral plate [4,6,11], a steep stiffness gradient [5], and a decrease of the ability to absorb energy [7]. Whether the size of subchondral bone is static or changes over time in subjects with OA is unknown
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