Messent Elizabeth A, Ward Rupert J, Tonkin Carol J, Buckland-Wright Christopher
Department of Applied Clinical Anatomy, King's College London, School of Biomedical Sciences, Guy's Hospital Campus, London, UK.
Osteoarthritis Cartilage. 2005 Jan;13(1):39-47. doi: 10.1016/j.joca.2004.10.009.
To quantify differences in bone structure in the proximal tibia of patients with mild, definite and advanced osteoarthritis (OA) compared to healthy reference tibiae.
Patients with medial compartment OA (n=110; F=70), mean+/-SD age 61.0+/-10.2 years, and non-OA reference subjects (n = 27; F = 10) mean+/-SD age 36.3+/-11.4 years had 4x macroradiographs digitised by laser scanner. Computer measurement of minimum medial joint space width (JSW) subdivided available OA knees into those with early (JSW > 3 mm, n=70), definite (JSW </= 3 > 1.5 mm, n = 52) and advanced OA (JSW </= 1.5 mm, n = 60). Non-OA knees (n = 49) had JSW > 4.5 mm. Fractal Signature Analysis (FSA), a computerised image analysis technique, measured differences in cancellous bone structure between OA and non-OA tibiae at four regions of interest (ROIs).
Compared to non-OA, FSA of vertical trabeculae increased significantly (P < 0.05) at most sizes (0.12-1.14 mm) in all OA subgroups and ROIs, with greatest increase occurring in the medial diseased compartment. Compared to early OA, FSA of vertical trabeculae increased significantly (P<0.05) at most sizes (0.36-1.14 mm) in subchondral and subarticular ROIs in definite and advanced OA. Compared to non-OA, FSA of horizontal trabeculae increased significantly (P < 0.05) at some small sizes in all ROIs and OA subgroups, and decreased significantly (P<0.05) at large sized horizontal trabeculae (0.60-1.14 mm) in the medial subarticular region in advanced OA.
The increase in FSA (consistent with increased trabecular number associated with thinning and fenestration in regions of dense cancellous bone) of most vertical and some horizontal trabeculae confirms that cancellous bone within the proximal tibia of OA patients is osteoporotic.
量化轻度、明确和重度骨关节炎（OA）患者胫骨近端的骨结构与健康对照胫骨之间的差异。
对内侧间室OA患者（n = 110；女性 = 70），平均±标准差年龄61.0±10.2岁，以及非OA对照受试者（n = 27；女性 = 10），平均±标准差年龄36.3±11.4岁，用激光扫描仪对4倍放大的X线片进行数字化处理。通过计算机测量最小内侧关节间隙宽度（JSW），将可用的OA膝关节分为早期（JSW > 3 mm，n = 70）、明确（JSW ≤ 3 > 1.5 mm，n = 52）和重度OA（JSW ≤ 1.5 mm，n = 60）。非OA膝关节（n = 49）的JSW > 4.5 mm。分形特征分析（FSA），一种计算机图像分析技术，测量了OA和非OA胫骨在四个感兴趣区域（ROI）的松质骨结构差异。
与非OA相比，所有OA亚组和ROI中，大多数尺寸（0.12 - 1.14 mm）的垂直小梁的FSA显著增加（P < 0.05），在内侧病变间室增加最为明显。与早期OA相比，在明确和重度OA的软骨下和关节下ROI中，大多数尺寸（0.36 - 1.14 mm）的垂直小梁的FSA显著增加（P < 0.05）。与非OA相比，所有ROI和OA亚组中，一些小尺寸的水平小梁的FSA显著增加（P < 0.05），在重度OA的内侧关节下区域，大尺寸水平小梁（0.60 - 1.14 mm）的FSA显著降低（P < 0.05）。
大多数垂直小梁和一些水平小梁的FSA增加（与松质骨致密区域小梁数量增加、小梁变薄和出现窗孔一致）证实OA患者胫骨近端的松质骨是骨质疏松性的。
