绝经后妇女骨关节炎和骨质疏松症的关节软骨和软骨下骨的差异：二维分析。

Differential articular calcified cartilage and subchondral bone in postmenopausal women with osteoarthritis and osteoporosis: two-dimensional analysis.

机构信息

Department of Orthopedic Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, 1665, Kongjiang Road, Shanghai 200092, China.

出版信息

Joint Bone Spine. 2009 Dec;76(6):674-9. doi: 10.1016/j.jbspin.2009.03.011.

DOI:10.1016/j.jbspin.2009.03.011

PMID:19646909

Abstract

OBJECTIVES

Osteoarthritis (OA) and osteoporosis (OP) are both common problems that affect life quality in aging society. It has been for decades of years to debate an inverse relationship between OA and OP. The objective of this paper was to compare structural properties of the articular calcified cartilage (ACC) and subchondral bone between postmenopausal women with OA and OP.

METHODS

Eight femoral heads were taken from postmenopausal women during total hip replacement surgery due to primary OA. They were compared with nine femoral heads obtained from age-matched women with OP during hemi-hip arthroplasty surgery due to osteoporotic fracture of the proximal femur. Two-dimensional histomorphometric sections were prepared to measure the thickness of ACC and bone histomorphometric parameters. The ratio of ACC to the total articular cartilage (TAC) was also calculated in all bone specimens.

RESULTS

Osteoarthritic donors had higher ACC and the ratio of ACC to TAC (ACC: 117.69+/-28.16 microm vs. 97.88+/-16.79 microm, P=0.041; the ratio of ACC to TAC: 15.74% vs. 10.51%, P=0.023). Lower bone volume fraction (BV/TV), trabecular thickness (Tb.Th), trabecular number (Tb.N) and the ratio of nodes to termini (Nd/Tm) were demonstrated in donors with OP (BV/TV: 21.55+/-3.41% vs. 16.64+/-2.26%, P=0.003; Tb.Th: 121.33+/-16.11 microm vs. 98.59+/-18.56 microm, P=0.017; Tb.N: 2.41+/-0.73 mm(-1) vs. 1.37+/-0.31 mm(-1), P=0.001; Nd/Tm: 0.78+/-0.22 vs. 0.50+/-0.14, P=0.007). However, trabecular space (Tb.Sp) increased in these osteoporotic patients (Tb.Sp: 345.49+/-106.18 microm vs. 652.09+/-159.71 microm, P=0.0004).

CONCLUSIONS

The pathogenesis of OA and OP were influenced by differential properties of ACC and subchondral bone microstructure. Structural properties of the subchondral mineralized tissue supported that an inverse relationship existed between postmenopausal women with OA and OP.

摘要

目的

骨关节炎（OA）和骨质疏松症（OP）都是影响老龄化社会生活质量的常见问题。几十年来，人们一直在争论 OA 和 OP 之间存在反比关系。本文的目的是比较绝经后 OA 和 OP 女性关节钙化软骨（ACC）和软骨下骨的结构特性。

方法

在全髋关节置换术中，从 8 名绝经后 OA 女性的股骨头中取出标本，与 9 名因股骨近端骨质疏松性骨折行半髋关节置换术的 OP 女性的股骨头进行比较。制备二维组织形态计量学切片，测量 ACC 厚度和骨组织形态计量学参数。还计算了所有骨标本中 ACC 与总关节软骨（TAC）的比值。

结果

OA 供体的 ACC 和 ACC 与 TAC 的比值（ACC：117.69+/-28.16 µm 比 97.88+/-16.79 µm，P=0.041；ACC 与 TAC 的比值：15.74%比 10.51%，P=0.023）更高。OP 供体的骨体积分数（BV/TV）、骨小梁厚度（Tb.Th）、骨小梁数量（Tb.N）和节点与末端比（Nd/Tm）均较低（BV/TV：21.55+/-3.41%比 16.64+/-2.26%，P=0.003；Tb.Th：121.33+/-16.11 µm 比 98.59+/-18.56 µm，P=0.017；Tb.N：2.41+/-0.73 mm(-1) 比 1.37+/-0.31 mm(-1)，P=0.001；Nd/Tm：0.78+/-0.22 比 0.50+/-0.14，P=0.007）。然而，这些骨质疏松症患者的骨小梁间隙（Tb.Sp）增加（Tb.Sp：345.49+/-106.18 µm 比 652.09+/-159.71 µm，P=0.0004）。