Cancellous bone differences between knees with early, definite and advanced joint space loss; a comparative...

Area of Science:

• Orthopedics
• Radiology
• Biomedical Engineering

Background:

• Osteoarthritis (OA) is a degenerative joint disease characterized by cartilage breakdown and bone remodeling.
• Understanding changes in subchondral bone structure is crucial for diagnosing and managing OA progression.

Purpose of the Study:

• To quantify differences in proximal tibial bone structure between healthy individuals and patients with varying stages of medial compartment osteoarthritis.
• To investigate alterations in cancellous bone architecture using advanced imaging analysis.

Main Methods:

• Macroradiographs of tibiae from 110 OA patients and 27 healthy controls were digitized.
• Joint space width (JSW) categorized OA severity: early (JSW > 3 mm), definite (JSW ≤ 3 > 1.5 mm), and advanced (JSW ≤ 1.5 mm).
• Fractal Signature Analysis (FSA) assessed cancellous bone structure in four regions of interest (ROIs).

Main Results:

• Fractal Signature Analysis (FSA) revealed significant increases in vertical trabeculae across all OA subgroups compared to controls, particularly in the medial compartment.
• Definite and advanced OA showed increased vertical trabeculae in subchondral and subarticular ROIs compared to early OA.
• Horizontal trabeculae showed increases at smaller sizes but significant decreases at larger sizes in the medial subarticular region of advanced OA tibiae.

Conclusions:

• The observed changes in trabecular structure, including increased vertical and altered horizontal trabeculae, indicate a significant alteration in bone quality.
• The findings suggest that cancellous bone in the proximal tibia of osteoarthritis patients exhibits osteoporotic characteristics.
• Fractal Signature Analysis (FSA) is a valuable tool for quantifying bone structural changes associated with osteoarthritis.