Messent E A, Ward R J, Tonkin C J, Buckland-Wright C
Department of Applied Clinical Anatomy, King's College London, School of Biomedical Sciences, Guy's Hospital Campus, London, UK.
Osteoarthritis Cartilage. 2007 Feb;15(2):179-86. doi: 10.1016/j.joca.2006.06.020. Epub 2006 Aug 14.
To determine differences in tibial cancellous bone organisation in knee osteoarthritis (OA) between the central weight-bearing region and juxta-articular radiolucencies adjacent to small, medium or large marginal osteophytes.
Patients with medial compartment OA (n = 60; F = 39), mean (SD) age 60.0 (9.7) years, and non-OA reference subjects (n = 21; F = 5), mean (SD) age 36.8 (11.5) years, had x4 macroradiographs digitised by laser scanner. Using a modified Osteoarthritis Research Society (OARS) Atlas, right and/or left knees were graded according to marginal osteophyte size into those with small (n = 30), medium (n = 30) or large (n = 27) marginal osteophytes, identified as OPH1, OPH2 and OPH3, respectively. Non-OA knees (n = 30) were anatomically normal. Computerised method of Fractal Signature Analysis (FSA) quantified differences in cancellous bone structure between non-OA and osteophyte subgroups at two regions of interest (ROIs); central weight-bearing and tibial margin.
Compared to non-OA, vertical trabecular number increased significantly (P < 0.05) in all osteophyte subgroups (width range 0.12-1.14 mm) within both ROIs. In OPH3, this increase was significantly (P < 0.05) greater compared to OPH2 in the central ROI, and to OPH2 and OPH1 in the marginal ROI at most trabecular widths (0.12-1.14 mm). In the marginal ROI, compared to non-OA, horizontal trabeculae number decreased in all osteophyte subgroups. This decrease was significantly greater in OPH3 compared to OPH2 and OPH1 at small to medium trabecular widths (0.12-0.54 mm).
Compared to disease associated bone loss at the central ROI of the tibia, the extent of juxta-articular bone loss appears to be associated with the size of the marginal osteophytes.
确定膝关节骨关节炎（OA）患者胫骨松质骨结构在中央负重区与毗邻小、中或大边缘骨赘的关节周围透亮区之间的差异。
对60例内侧间室OA患者（女性39例），平均（标准差）年龄60.0（9.7）岁，以及21例非OA对照者（女性5例），平均（标准差）年龄36.8（11.5）岁，用激光扫描仪对其4张X线放大像进行数字化处理。使用改良的骨关节炎研究学会（OARS）图谱，根据边缘骨赘大小将右膝和/或左膝分为小（n = 30）、中（n = 30）或大（n = 27）边缘骨赘组，分别记为OPH1、OPH2和OPH3。30例非OA膝关节解剖结构正常。采用分形特征分析（FSA）计算机化方法，定量分析非OA组与骨赘亚组在两个感兴趣区域（ROI），即中央负重区和胫骨边缘区的松质骨结构差异。
与非OA组相比，所有骨赘亚组（宽度范围0.12 - 1.14 mm）在两个ROI内垂直小梁数量均显著增加（P < 0.05）。在中央ROI中，OPH3组的垂直小梁数量增加幅度明显大于OPH2组（P < 0.05）；在边缘ROI中，在大多数小梁宽度（0.12 - 1.14 mm）时，OPH3组的垂直小梁数量增加幅度明显大于OPH2组和OPH1组。在边缘ROI中，与非OA组相比，所有骨赘亚组水平小梁数量均减少。在小至中等小梁宽度（0.12 - 0.54 mm）时，OPH3组水平小梁数量减少幅度明显大于OPH2组和OPH1组。
与胫骨中央ROI处与疾病相关的骨质流失相比，关节周围骨质流失程度似乎与边缘骨赘大小有关。
