Rheumatology & Clinical Immunology, University Medical Center Utrecht, Utrecht, The Netherlands.
Osteoarthritis Cartilage. 2010 May;18(5):691-8. doi: 10.1016/j.joca.2010.01.004. Epub 2010 Feb 6.
The pathogenesis of osteoarthritis (OA) includes cartilage degeneration, synovial inflammation, and bone changes. Slowly, the sequence and inter-relationship of these features is becoming clearer. Early models of OA suggest thinning of the subchondral plate in addition to trabecular bone changes. In the present study subchondral bone changes were studied in the canine anterior cruciate ligament transection (ACLT)-meniscectomy model. This model is characterized by intra-joint variability with respect to cartilage damage (predominantly medial) and loading (lateral unloading due to a shifted axis).
In 13 Labrador dogs, OA was induced by transection of the anterior cruciate ligament and removal of the medial meniscus. Twelve weeks later, cartilage integrity was evaluated histologically using the modified Mankin score (0-11), and proteoglycan content was determined by Alcian Blue assay. Bone architecture of the tibia was quantified by micro-CT.
Cartilage damage was severe in the medial compartment (Mankin score +3.5, glycosaminoglycan (GAG) content -28%) and mild in the lateral compartment (Mankin score +1.6, GAG content -15%). Thinning and porosity of the subchondral plate were only present on the medial side (-21%, +87%, respectively). Interestingly, changes in trabecular bone structure did almost not occur in the medial compartment (volume fraction -7%) but were clear in the lateral compartment (-20%).
Thinning of the subchondral plate is a localized phenomenon related to cartilage degeneration while trabecular bone changes are related to mechanical (un)loading. The different mechanisms responsible for bone changes in OA should be taken in account when designing and interpreting studies interfering with bone turnover in the treatment of OA.
骨关节炎(OA)的发病机制包括软骨退变、滑膜炎症和骨改变。这些特征的顺序和相互关系逐渐变得更加清晰。OA 的早期模型表明,除了小梁骨变化外,软骨下板也变薄。在本研究中,研究了犬前交叉韧带切断(ACLT)-半月板切除术模型中的软骨下骨变化。该模型的特点是关节内软骨损伤(主要是内侧)和载荷(由于轴偏移导致的外侧卸载)存在变异性。
在 13 只拉布拉多犬中,通过切断前交叉韧带和切除内侧半月板来诱导 OA。12 周后,使用改良的 Mankin 评分(0-11)对软骨完整性进行组织学评估,并通过 Alcian Blue 测定法确定糖胺聚糖(GAG)含量。通过微 CT 定量胫骨的骨结构。
内侧间室的软骨损伤严重(Mankin 评分+3.5,GAG 含量-28%),外侧间室的软骨损伤轻微(Mankin 评分+1.6,GAG 含量-15%)。仅在内侧出现软骨下板变薄和多孔性(分别为-21%和+87%)。有趣的是,内侧间室的小梁骨结构变化几乎没有发生(体积分数-7%),而在外侧间室则很明显(-20%)。
软骨下板变薄是一种与软骨退变相关的局部现象,而小梁骨变化与机械(未)加载有关。在设计和解释干扰 OA 骨转换的研究时,应考虑到 OA 中导致骨变化的不同机制。