Chinese Journal of Tissue Engineering Research ›› 2020, Vol. 24 ›› Issue (15): 2399-2404.doi: 10.3969/j.issn.2095-4344.2588

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Ultrastructural changes of tibial subchondral bone in patients with knee osteoarthritis: CT evaluation

Luo Xiaofei1, Wei Xuan1, Wang Jinliang1, Wang Shaohua1, Li Zhe1, Bai Yu2   

  1. 1Second Department of Joint, 2Department of Neck, Shoulder, Waist and Leg Pain, Zhengzhou Orthopedic Hospital, Zhengzhou 450052, Henan Province, China
  • Received:2019-10-09 Revised:2019-10-10 Accepted:2019-11-07 Online:2020-05-28 Published:2020-03-23
  • Contact: Bai Yu, Chief physician, Department of Neck, Shoulder, Waist and Leg Pain, Zhengzhou Orthopedic Hospital, Zhengzhou 450052, Henan Province, China
  • About author:Luo Xiaofei, Master, Attending physician, Second Department of Joint, Zhengzhou Orthopedic Hospital, Zhengzhou 450052, Henan Province, China
  • Supported by:
    the Special Project for Scientific Research of Traditional Chinese Medicine in Henan Province, No. 2015ZY02080

Abstract:

BACKGROUND: More and more attention has been paid to the role of subchondral bone changes in knee osteoarthritis. However, previous studies mainly focused on animal experiments. Animals and humans have certain differences, so it is very necessary to obtain relevant data directly in human joints.

OBJECTIVE: To evaluate the difference of subchondral plate and subchondral bone ultrastructure between normal patients and patients with knee osteoarthritis by CT technique, so as to explore the role of subchondral bone in the occurrence and development of knee osteoarthritis.

METHODS: CT scan data of 30 patients with knee osteoarthritis (knee osteoarthritis group) and 30 patients without knee osteoarthritis (non-knee osteoarthritis group) were collected from the Department of Imaging of Zhengzhou Orthopedic Hospital from July 2016 to July 2018. Subchondral plate and subchondral bone ultrastructure of medial and lateral tibial plateau was compared between the two groups using MIMICS software. This study was approved by the Ethics Committee of Zhengzhou Orthopedic Hospital on June 10, 2016 (approval No. 2016 004).

RESULTS AND CONCLUSION: (1) Compared with the non-knee osteoarthritis group, bone density was significantly increased and porosity was significantly decreased in the subchondral bone plate in the knee osteoarthritis group in both the lateral and medial parts, while the medial part of subchondral bone plate thickness was significantly thicker than that in the non-knee osteoarthritis group. (2) There were also significant changes in subchondral trabeculae in the knee osteoarthritis group, which showed that the thickness of subchondral trabeculae in the lateral part and the medial part of the subchondral bone in the knee osteoarthritis group was significantly increased compared with the non-knee osteoarthritis group. Meanwhile, in the medial part, the degree of cancellous bone separation in the knee osteoarthritis group was significantly lower than that in the non-knee osteoarthritis group. Structure model index and connectivity density in the knee osteoarthritis group were significantly lower than those of the non-knee osteoarthritis group. (3) Results show that the change of tibial subchondral bone plate and subchondral cancellous bone in knee osteoarthritis patients mainly lies in the destruction of ultrastructure homeostasis. This change may be one of the causes of knee osteoarthritis.

Key words: knee osteoarthritis, subchondral bone, Computerized Tomography, ultrastructure, homeostasis, bone mineral density, porosity, three-dimensional reconstruction

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