Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-Cho, Hirosaki, Aomori, 036-8562, Japan.
Department of Orthopaedic Surgery, Hirosaki Memorial Hospital, Hirosaki, Japan.
Sci Rep. 2023 Apr 21;13(1):6516. doi: 10.1038/s41598-023-33251-7.
This retrospective cross-sectional study investigated the association between bone marrow lesions (BMLs) and bone mineral density (BMD) in the proximal tibia of end-stage osteoarthritic knees from a large patient sample. Overall, 1308 end-stage osteoarthritic knees were enrolled before total knee arthroplasty. The preoperative range of motion was recorded. Bone mineral density in the medial tibial plateau (MTP), lateral tibial plateau (LTP), and metaphysis were measured using dual-energy X-ray absorptiometry. The MTP/LTP, MTP/metaphysis, and LTP/metaphysis ratios were calculated. BMLs were scored using a whole-organ magnetic resonance imaging scoring system. The relationship between BMD and BML scores was investigated using linear regression analysis. The highest BMD was 0.787 ± 0.176 g/cm at the MTP, followed by 0.676 ± 0.180 g/cm and 0.572 ± 0.145 g/cm at the metaphysis and LTP, respectively. The prevalence of BMLs was 90.4% and 24.2% in the MTP and LTP, respectively. In women, higher BML scores at the MTP were positively correlated with the BMD of the MTP (p < 0.001, r = 0.278), MTP/LTP (p < 0.001, r = 0.267), and MTP/metaphysis ratios (p < 0.001, r = 0.243). Regression analysis showed that higher BML scores in the MTP were correlated with higher BMD in the MTP (p < 0.001) and lower BMD in the LTP (p < 0.001). High BML scores in the MTP were positively associated with high BMD in the MTP, which also induced the medial to lateral imbalance of BMD in the proximal tibia.
本回顾性横断面研究调查了来自大样本患者的终末期骨关节炎膝关节中骨髓病变（BML）与胫骨近端骨密度（BMD）之间的关系。在全膝关节置换术前，共纳入了 1308 例终末期骨关节炎膝关节。记录了术前活动范围。使用双能 X 线吸收法测量内侧胫骨平台（MTP）、外侧胫骨平台（LTP）和干骺端的骨密度。计算了 MTP/LTP、MTP/干骺端和 LTP/干骺端比值。使用全器官磁共振成像评分系统对 BML 进行评分。使用线性回归分析研究了 BMD 与 BML 评分之间的关系。MTP 处的 BMD 最高，为 0.787±0.176 g/cm，其次是 0.676±0.180 g/cm 和 0.572±0.145 g/cm 位于干骺端和 LTP。MTP 和 LTP 处 BML 的患病率分别为 90.4%和 24.2%。在女性中，MTP 处较高的 BML 评分与 MTP 的 BMD 呈正相关（p<0.001，r=0.278）、MTP/LTP（p<0.001，r=0.267）和 MTP/干骺端比值（p<0.001，r=0.243）。回归分析表明，MTP 处较高的 BML 评分与 MTP 处较高的 BMD 相关（p<0.001）和 LTP 处较低的 BMD 相关（p<0.001）。MTP 处较高的 BML 评分与 MTP 处较高的 BMD 呈正相关，这也导致了胫骨近端 BMD 的内侧到外侧的失衡。
