Is Osteoarthritis a Vascular Disease?
Jon Olansen1, Jonathan P Dyke2, Roy K Aaron1
1Department of Orthopedic Surgery, Warren Alpert Medical School of Brown University, Providence, RI 02903, USA.
Frontiers in Bioscience (Landmark Edition)
|March 27, 2024
Summary
Osteoarthritis (OA) involves subchondral bone changes, where decreased bone perfusion precedes cartilage damage. This vascular component, indicated by imaging, is key to OA
Area of Science:
- Orthopedics and Sports Medicine
- Radiology
- Biomedical Engineering
Background:
- Osteoarthritis (OA) is a complex joint disease affecting cartilage, bone, and synovium.
- Subchondral bone's role in OA pathophysiology, particularly its vascularity, is increasingly recognized.
- Altered subchondral bone perfusion, including venous outflow reduction and hypertension, impacts joint health.
Purpose of the Study:
- To investigate the role of subchondral bone perfusion in osteoarthritis.
- To determine if decreased bone perfusion precedes or correlates with cartilage degeneration.
- To explore the relationship between bone vascularity and OA progression.
Main Methods:
- Dynamic contrast-enhanced MRI (DCE-MRI) to quantify subchondral bone perfusion kinetics.
- Pharmacokinetic analysis of DCE-MRI data to assess tracer clearance and outflow obstruction.
- 18F-Fluoride Positron Emission Tomography (PET) scanning to evaluate bone blood flow and metabolism.
Main Results:
- Decreased subchondral bone perfusion was observed in osteoarthritic subjects (guinea pigs and humans).
- Reduced perfusion temporally preceded and spatially correlated with cartilage lesions.
- DCE-MRI showed decreased tracer clearance and outflow obstruction in osteoarthritic subchondral bone.
- 18F-Fluoride PET revealed relationships between bone blood flow, cartilage lesions, and metabolic activity.
Conclusions:
- Decreased subchondral bone perfusion is a significant factor in osteoarthritis pathophysiology.
- Vascular changes, including venous stasis and outflow obstruction, contribute to cartilage degeneration.
- Imaging techniques like DCE-MRI and PET are valuable for understanding OA's vascular component.
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