Bareither D, Manion B L, Sumner D R, Berzins A, Albright T B, Rottier F, Muehleman C
Department of Basic Biomedical Sciences, Scholl College of Podiatric Medicine, Chicago, IL 60610, USA.
J Foot Ankle Surg. 1998 Sep-Oct;37(5):401-9. doi: 10.1016/s1067-2516(98)80049-5.
It is well known that bone changes occur in relationship to the articular cartilage damage seen in osteoarthritis. Numerous studies have shown a relationship between bone density and articular cartilage damage in knee and hip joints, but it is controversial as to whether or not an increased subchondral bone density results in greater cartilage damage. We studied 49 pairs of cadaveric first metatarsals in an attempt to correlate the level of cartilage damage seen on the distal articular surface with areal and volumetric density and other parameters such as bone geometry. A positive correlation was detected between articular cartilage damage and bone density by peripheral quantitative computed tomography in five of eight frontal slices in the head of the left metatarsal in the male sample only. The more extensive subchondral cysts found in the right male metatarsal may have contributed to the lack of correlation between the two variables on the right side. In addition, females displayed significantly greater osteophytosis than males at a given grade of cartilage damage, thus, possibly leading to a painful, apropulsive gait and a disuse osteopenia which would neutralize any subchondral bone density increase associated with cartilage damage. Microscopic investigations are, therefore, warranted to detect bone changes on a more discreet level, particularly within the subchondral plate.
众所周知，骨变化与骨关节炎中出现的关节软骨损伤相关。大量研究表明，膝关节和髋关节的骨密度与关节软骨损伤之间存在关联，但关于软骨下骨密度增加是否会导致更严重的软骨损伤仍存在争议。我们研究了49对尸体第一跖骨，试图将远端关节表面的软骨损伤程度与面积密度、体积密度以及其他参数（如骨几何结构）联系起来。仅在男性样本中，通过外周定量计算机断层扫描在左跖骨头的八个额状面切片中的五个中检测到关节软骨损伤与骨密度之间存在正相关。在右侧男性跖骨中发现的更广泛的软骨下囊肿可能导致了右侧这两个变量之间缺乏相关性。此外，在给定的软骨损伤等级下，女性的骨赘形成明显比男性更严重，因此，这可能导致疼痛、推进性步态和废用性骨质减少，从而抵消与软骨损伤相关的任何软骨下骨密度增加。因此，有必要进行微观研究以在更细微的层面检测骨变化，特别是在软骨下板内。
