Institute of Medical Physics, University of Erlangen-Nürnberg, Henkestr 91, 91052 Erlangen, Germany.
Service de Radiologie, Hôpital Lariboisière, APHP & Université Paris-Diderot, Paris, France; B2OA UMR 7052 CNRS, Université Paris Diderot, 10 Avenue de Verdun, 75010 Paris, France.
Bone. 2020 May;134:115292. doi: 10.1016/j.bone.2020.115292. Epub 2020 Feb 19.
To verify earlier data in cadavers that in female subjects with OA meniscal coverage is associated with lowered bone mineral density of the underlying subchondral bone in the proximal tibia by investigating the local bone mineral density (BMD) distribution within the epiphysis.
BMD of the subchondral bone of the tibia was measured by QCT in 67 elderly females diagnosed with OA (Kellgren-Lawrence grades 2-3). The epiphysis was subdivided along the axis of the tibia into a subchondral-epiphyseal VOI covering the first 5-6 mm below the subchondral bone plate, a mid-epiphyseal VOI covering the adjacent 7-8 and a juxtaphyseal VOI of another 7-8 mm that bordered the growth plate. These VIOs were further divided into lateral and medial and then into anterior, mid and posterior sub-VOIs. Finally, all subVOIs were divided in one subVOI covered by the menisci (CM) and another not covered by the menisci (nCM). BMD ratios of these two subVOIs were compared.
In the subchondral epiphysis BMD was significantly lower (Medial: mean BMD = 125 mg/cm, p<0.001; Lateral: mean BMD = 56 mg/cmp < 0.001) in subVOIs covered by the meniscus compared to subVOIs not covered by the meniscus. The BMD difference was no longer significant in the mid epiphysis (Medial: mean BMD = 10 mg/cm, p>0.82; Lateral: mean BMD = 7 mg/cm, p=0.99) and was reversed in the juxtaphysis. With a few exceptions these BMD differences were independent of the lateral-medial and the anterior-mid-posterior position. BMD significantly (p<0.05) decreased with age independent on whether the location was covered or uncovered by the meniscus, however the BMD ratio of the corresponding nCM and CM subVOIs did not significantly (p>0.1) change with age.
In-vivo QCT measurements of the BMD distribution in the proximal tibia indicate a protective effect of the menisci in the subchondral bone close to the joint. This protective effect is age independent despite the overall age-related decrease of BMD.
通过研究骺骨内的局部骨密度（BMD）分布，验证先前在尸体上的研究数据，即对于患有 OA 的女性受试者，半月板覆盖与胫骨近侧骺骨下的软骨下骨的骨密度降低有关。
通过定量 CT（QCT）对 67 名被诊断为 OA（Kellgren-Lawrence 分级 2-3）的老年女性的胫骨软骨下骨的 BMD 进行测量。骺骨沿胫骨轴分为软骨下骺骨 VOI，该 VOI 覆盖软骨下骨板下的前 5-6mm；中间骺骨 VOI 覆盖相邻的 7-8mm；以及毗邻生长板的近骺骨 VOI，其为另外 7-8mm。这些 VOI 进一步分为外侧和内侧，然后再分为前、中、后亚 VOI。最后，将所有的亚 VOI 分为一个由半月板覆盖的亚 VOI（CM）和另一个不由半月板覆盖的亚 VOI（nCM）。比较这两个亚 VOI 的 BMD 比值。
在软骨下骺骨中，半月板覆盖的亚 VOI 的 BMD 明显较低（内侧：平均 BMD=125mg/cm，p<0.001；外侧：平均 BMD=56mg/cm，p<0.001），与不由半月板覆盖的亚 VOI 相比。在中间骺骨中，BMD 差异不再显著（内侧：平均 BMD=10mg/cm，p>0.82；外侧：平均 BMD=7mg/cm，p=0.99），并且在近骺骨中逆转。除了少数例外，这些 BMD 差异与外侧-内侧和前-中-后位置无关。BMD 随着年龄的增长而显著（p<0.05）降低，与位置是否被半月板覆盖无关，但是相应的 nCM 和 CM 亚 VOI 的 BMD 比值并没有随着年龄的增长而显著（p>0.1）变化。
对胫骨近侧骺骨 BMD 分布的体内 QCT 测量表明，半月板在靠近关节的软骨下骨中具有保护作用。尽管 BMD 整体呈年龄相关性下降，但这种保护作用与年龄无关。
