Skip to main content
Erschienen in: Osteoporosis International 3/2014

01.03.2014 | Original Article

Regional depth-specific subchondral bone density measures in osteoarthritic and normal patellae: in vivo precision and preliminary comparisons

verfasst von: W. D. Burnett, S. A. Kontulainen, C. E. McLennan, D. J. Hunter, D. R. Wilson, J. D. Johnston

Erschienen in: Osteoporosis International | Ausgabe 3/2014

Einloggen, um Zugang zu erhalten

Abstract

Summary

Computed tomography-based depth-specific image processing is able to precisely identify regional differences between healthy patellae and patellae with osteoarthritis.

Introduction

This study aims to assess the precision errors and potential differences in regional, depth-specific subchondral bone mineral density (BMD) in normal and osteoarthritic (OA) human patellae in vivo using CT-based density analyses.

Methods

Fourteen participants (2 men and 12 women; mean age, 51.4; SD, 11.8 years) were scanned using clinical quantitative CT (QCT) three times over 2 days. Participants were categorized as either normal (n = 7) or exhibiting radiographic OA (n = 7). Average subchondral BMD was assessed at three depths relative to the subchondral surface. Regional BMD analysis included: total lateral facet BMD, total medial facet BMD, and superior/middle/inferior BMD of lateral and medial facets at normalized depths of 0–2.5, 2.5–5, and 5–7.5 mm from the subchondral surface. We assessed precision using root mean square coefficients of variation (CV%). We evaluated differences between OA and normal BMD by (1) calculating percentage differences between the groups (in relation to normal BMD) (2) relating percentage differences to respective CV% errors and (3) determining effect sizes using Cohen’s d.

Results

Root mean square CV% precision errors ranged from 1.1 to 5.9 %. Percentage differences between OA and normal BMD varied from −1.6 to −30.1 % (BMD lower in OA patellae). In relation to precision errors, percentage differences were, on average, 5.5× greater than CV% errors. Cohen’s d effect sizes ranged from −1.7 to −0.1. Largest differences were noted at depths of 2.5–5 and 5–7.5 mm from the subchondral surface.

Conclusions

Patellar subchondral BMD measures were precise (average CV%, ≤3 %). This region- and depth-specific CT-based imaging tool characterized regional standardized BMD differences between normal and OA patellae in vivo.
Literatur
1.
Zurück zum Zitat Crossley KM, Hinman RS (2011) The patellofemoral joint: the forgotten joint in knee osteoarthritis. Osteoarthr Cartil 19:765–767PubMedCrossRef Crossley KM, Hinman RS (2011) The patellofemoral joint: the forgotten joint in knee osteoarthritis. Osteoarthr Cartil 19:765–767PubMedCrossRef
2.
Zurück zum Zitat Hinman RS, Crossley KM (2007) Patellofemoral joint osteoarthritis: an important subgroup of knee osteoarthritis. Rheumatology 46:1057–1062PubMedCrossRef Hinman RS, Crossley KM (2007) Patellofemoral joint osteoarthritis: an important subgroup of knee osteoarthritis. Rheumatology 46:1057–1062PubMedCrossRef
3.
Zurück zum Zitat Cicuttini FM, Baker J, Hart DJ, Spector TD (1996) Association of pain with radiological changes in different compartments and views of the knee joint. Osteoarthr Cartil 4:143–147PubMedCrossRef Cicuttini FM, Baker J, Hart DJ, Spector TD (1996) Association of pain with radiological changes in different compartments and views of the knee joint. Osteoarthr Cartil 4:143–147PubMedCrossRef
4.
Zurück zum Zitat McAlindon TE, Snow S, Cooper C, Dieppe PA (1992) Radiographic patterns of osteoarthritis in the knee joint in the community: The importance of the patellofemoral joint. Ann Rheum Dis 51:844–849PubMedCrossRef McAlindon TE, Snow S, Cooper C, Dieppe PA (1992) Radiographic patterns of osteoarthritis in the knee joint in the community: The importance of the patellofemoral joint. Ann Rheum Dis 51:844–849PubMedCrossRef
5.
Zurück zum Zitat Szebenyi B, Hollander AP, Dieppe P, Quilty B, Duddy J, Clarke S, Kirwan JR (2006) Associations between pain, function, and radiographic features in osteoarthritis of the knee. Arthritis Rheum 54:230–235PubMedCrossRef Szebenyi B, Hollander AP, Dieppe P, Quilty B, Duddy J, Clarke S, Kirwan JR (2006) Associations between pain, function, and radiographic features in osteoarthritis of the knee. Arthritis Rheum 54:230–235PubMedCrossRef
6.
Zurück zum Zitat Duncan R, Peat G, Thomas E, Wood L, Hay E, Croft P (2008) How do pain and function vary with compartmental distribution and severity of radiographic knee osteoarthritis? Rheumatology 47:1704–1707PubMedCrossRef Duncan R, Peat G, Thomas E, Wood L, Hay E, Croft P (2008) How do pain and function vary with compartmental distribution and severity of radiographic knee osteoarthritis? Rheumatology 47:1704–1707PubMedCrossRef
7.
Zurück zum Zitat Felson DT, Chaisson CE, Hill CL, Totterman SM, Gale ME, Skinner KM, Kazis L, Gale DR (2001) The association of bone marrow lesions with pain in knee osteoarthritis. Ann Intern Med 134:541–549PubMedCrossRef Felson DT, Chaisson CE, Hill CL, Totterman SM, Gale ME, Skinner KM, Kazis L, Gale DR (2001) The association of bone marrow lesions with pain in knee osteoarthritis. Ann Intern Med 134:541–549PubMedCrossRef
8.
Zurück zum Zitat Hunter DJ, Lo GH, Gale D, Grainger AJ, Guermazi A, Conaghan PG (2008) The reliability of a new scoring system for knee osteoarthritis MRI and the validity of bone marrow lesion assessment: BLOKS (Boston Leeds Osteoarthritis Knee Score). Ann Rheum Dis 67:206–211PubMedCrossRef Hunter DJ, Lo GH, Gale D, Grainger AJ, Guermazi A, Conaghan PG (2008) The reliability of a new scoring system for knee osteoarthritis MRI and the validity of bone marrow lesion assessment: BLOKS (Boston Leeds Osteoarthritis Knee Score). Ann Rheum Dis 67:206–211PubMedCrossRef
9.
Zurück zum Zitat Sowers MF, Hayes C, Jamadar D, Capul D, Lachance L, Jannausch M, Welch G (2003) Magnetic resonance-detected subchondral bone marrow and cartilage defect characteristics associated with pain and X-ray-defined knee osteoarthritis. Osteoarthr Cartil 11:387–393PubMedCrossRef Sowers MF, Hayes C, Jamadar D, Capul D, Lachance L, Jannausch M, Welch G (2003) Magnetic resonance-detected subchondral bone marrow and cartilage defect characteristics associated with pain and X-ray-defined knee osteoarthritis. Osteoarthr Cartil 11:387–393PubMedCrossRef
10.
Zurück zum Zitat Torres L, Dunlop DD, Peterfy C et al (2006) The relationship between specific tissue lesions and pain severity in persons with knee osteoarthritis. Osteoarthr Cartil 14:1033–1040PubMedCrossRef Torres L, Dunlop DD, Peterfy C et al (2006) The relationship between specific tissue lesions and pain severity in persons with knee osteoarthritis. Osteoarthr Cartil 14:1033–1040PubMedCrossRef
11.
Zurück zum Zitat Lammentausta E, Hakulinen MA, Jurvelin JS, Nieminen MT (2006) Prediction of mechanical properties of trabecular bone using quantitative MRI. Phys Med Biol 51:6187–6198PubMedCrossRef Lammentausta E, Hakulinen MA, Jurvelin JS, Nieminen MT (2006) Prediction of mechanical properties of trabecular bone using quantitative MRI. Phys Med Biol 51:6187–6198PubMedCrossRef
12.
Zurück zum Zitat Bayar A, Sarikaya S, Keser S, Ozdolap S, Tuncay I, Ege A (2008) Regional bone density changes in anterior cruciate ligament deficient knees: a DEXA study. Knee 15:373–377PubMedCrossRef Bayar A, Sarikaya S, Keser S, Ozdolap S, Tuncay I, Ege A (2008) Regional bone density changes in anterior cruciate ligament deficient knees: a DEXA study. Knee 15:373–377PubMedCrossRef
13.
Zurück zum Zitat Watts NB (2004) Fundamentals and pitfalls of bone densitometry using dual-energy X-ray absorptiometry (DXA). Osteoporos Int 15:847–854PubMedCrossRef Watts NB (2004) Fundamentals and pitfalls of bone densitometry using dual-energy X-ray absorptiometry (DXA). Osteoporos Int 15:847–854PubMedCrossRef
14.
Zurück zum Zitat Leppala J, Kannus P, Natri A, Sievanen H, Jarvinen M, Vuori I (1998) Bone mineral density in the chronic patellofemoral pain syndrome. Calcif Tissue Int 62:548–553PubMedCrossRef Leppala J, Kannus P, Natri A, Sievanen H, Jarvinen M, Vuori I (1998) Bone mineral density in the chronic patellofemoral pain syndrome. Calcif Tissue Int 62:548–553PubMedCrossRef
15.
Zurück zum Zitat Wright DA, Meguid M, Lubovsky O, Whyne CM (2011) Subchondral bone density distribution in the human femoral head. Skelet Radiol 41:677–683CrossRef Wright DA, Meguid M, Lubovsky O, Whyne CM (2011) Subchondral bone density distribution in the human femoral head. Skelet Radiol 41:677–683CrossRef
16.
Zurück zum Zitat Speirs AD, Beaulé PE, Rakhra KS, Schweitzer ME, Frei H (2013) Increased acetabular subchondral bone density is associated with cam-type femoroacetabular impingement. Osteoarthr Cartil 21:551–558PubMedCrossRef Speirs AD, Beaulé PE, Rakhra KS, Schweitzer ME, Frei H (2013) Increased acetabular subchondral bone density is associated with cam-type femoroacetabular impingement. Osteoarthr Cartil 21:551–558PubMedCrossRef
17.
Zurück zum Zitat Intema F, Thomas TP, Anderson DD, Elkins JM, Brown TD, Amendola A, Lafeber FP, Saltzman CL (2011) Subchondral bone remodeling is related to clinical improvement after joint distraction in the treatment of ankle osteoarthritis. Osteoarthr Cartil 19:668–675PubMedCentralPubMedCrossRef Intema F, Thomas TP, Anderson DD, Elkins JM, Brown TD, Amendola A, Lafeber FP, Saltzman CL (2011) Subchondral bone remodeling is related to clinical improvement after joint distraction in the treatment of ankle osteoarthritis. Osteoarthr Cartil 19:668–675PubMedCentralPubMedCrossRef
18.
Zurück zum Zitat Johnston JD, Kontulainen SA, Masri BA, Wilson DR (2010) A comparison of conventional maximum intensity projection with a new depth-specific topographic mapping technique in the CT analysis of proximal tibial subchondral bone density. Skelet Radiol 39:867–876CrossRef Johnston JD, Kontulainen SA, Masri BA, Wilson DR (2010) A comparison of conventional maximum intensity projection with a new depth-specific topographic mapping technique in the CT analysis of proximal tibial subchondral bone density. Skelet Radiol 39:867–876CrossRef
19.
Zurück zum Zitat (2000) UNSCEAR 2000 Report to the General Assembly, Volume 1. Sources and Effects of Ionizing Radiation. United Nations Scientific Committee on the Effects of Atomic Radiation (2000) UNSCEAR 2000 Report to the General Assembly, Volume 1. Sources and Effects of Ionizing Radiation. United Nations Scientific Committee on the Effects of Atomic Radiation
20.
Zurück zum Zitat Johnston JD, Masri BA, Wilson DR (2009) Computed tomography topographic mapping of subchondral density (CT-TOMASD) in osteoarthritic and normal knees: methodological development and preliminary findings. Osteoarthr Cartil 17:1319–1326PubMedCrossRef Johnston JD, Masri BA, Wilson DR (2009) Computed tomography topographic mapping of subchondral density (CT-TOMASD) in osteoarthritic and normal knees: methodological development and preliminary findings. Osteoarthr Cartil 17:1319–1326PubMedCrossRef
21.
Zurück zum Zitat Johnston JD, McLennan CE, Hunter DJ, Wilson DR (2010) In vivo precision of a depth-specific topographic mapping technique in the CT analysis of osteoarthritic and normal proximal tibial subchondral bone density. Skelet Radiol 40:1057–1064CrossRef Johnston JD, McLennan CE, Hunter DJ, Wilson DR (2010) In vivo precision of a depth-specific topographic mapping technique in the CT analysis of osteoarthritic and normal proximal tibial subchondral bone density. Skelet Radiol 40:1057–1064CrossRef
22.
Zurück zum Zitat Kontulainen S, Liu D, Manske S, Jamieson M, Sievänen H, McKay H (2007) Analyzing cortical bone cross-sectional geometry by peripheral QCT: comparison with bone histomorphometry. J Clin Densitom 10:86–92PubMedCrossRef Kontulainen S, Liu D, Manske S, Jamieson M, Sievänen H, McKay H (2007) Analyzing cortical bone cross-sectional geometry by peripheral QCT: comparison with bone histomorphometry. J Clin Densitom 10:86–92PubMedCrossRef
23.
Zurück zum Zitat Spoor CF, Zonneveld FW, Macho GA (1993) Linear measurements of cortical bone and dental enamel by computed tomography: applications and problems. Am J Phys Anthropol 91:469–484PubMedCrossRef Spoor CF, Zonneveld FW, Macho GA (1993) Linear measurements of cortical bone and dental enamel by computed tomography: applications and problems. Am J Phys Anthropol 91:469–484PubMedCrossRef
24.
Zurück zum Zitat Harris RM (2006) Fractures of the patella and injuries to the extensor mechanism. In: Bucholz RW, Heckman JD, Court-Brown C (eds) Rockwood and Green’s fractures in adults, 6th edn. Lippincott, Williams & Wilkins, Philadelphia, pp 1969–1997 Harris RM (2006) Fractures of the patella and injuries to the extensor mechanism. In: Bucholz RW, Heckman JD, Court-Brown C (eds) Rockwood and Green’s fractures in adults, 6th edn. Lippincott, Williams & Wilkins, Philadelphia, pp 1969–1997
25.
Zurück zum Zitat Eckstein F, Milz S, Anetzberger H, Putz R (1998) Thickness of the subchondral mineralised tissue zone (SMZ) in normal male and female and pathological human patellae. J Anat 192:10CrossRef Eckstein F, Milz S, Anetzberger H, Putz R (1998) Thickness of the subchondral mineralised tissue zone (SMZ) in normal male and female and pathological human patellae. J Anat 192:10CrossRef
26.
Zurück zum Zitat Kellgren JH, Lawrence JS (1957) Radiological assessment of osteo-arthrosis. Ann Rheum Dis 16:494–502PubMedCrossRef Kellgren JH, Lawrence JS (1957) Radiological assessment of osteo-arthrosis. Ann Rheum Dis 16:494–502PubMedCrossRef
27.
Zurück zum Zitat Chan WP, Lang P, Stevens MP, Sack K, Majumdar S, Stoller DW, Basch C, Genant HK (1991) Osteoarthritis of the knee: comparison of radiography, CT, and MR imaging to assess extent and severity. Am J Radiol 157:799–806 Chan WP, Lang P, Stevens MP, Sack K, Majumdar S, Stoller DW, Basch C, Genant HK (1991) Osteoarthritis of the knee: comparison of radiography, CT, and MR imaging to assess extent and severity. Am J Radiol 157:799–806
28.
Zurück zum Zitat Glüer CC, Blake G, Lu Y, Blunt BA, Jergas M, Genant HK (1995) Accurate assessment of precision errors: how to measure the reproducibility of bone densitometry techniques. Osteoporos Int 5:262–270PubMedCrossRef Glüer CC, Blake G, Lu Y, Blunt BA, Jergas M, Genant HK (1995) Accurate assessment of precision errors: how to measure the reproducibility of bone densitometry techniques. Osteoporos Int 5:262–270PubMedCrossRef
29.
Zurück zum Zitat Cohen J (1988) Statistical power analysis for the behavioral sciences. Erlbaum, Hillsdale, NJ Cohen J (1988) Statistical power analysis for the behavioral sciences. Erlbaum, Hillsdale, NJ
30.
Zurück zum Zitat Wolf FM (1986) Meta-analysis: quantitative methods for research synthesis. Sage, Newbury, London Wolf FM (1986) Meta-analysis: quantitative methods for research synthesis. Sage, Newbury, London
31.
Zurück zum Zitat Katada K, Fujii N, Ogura Y, Hayakawa M, Koga S (2001) Usefulness of isotropic volumetric data in neuroradiological diagnosis. In: Reiser MF, Takahashi M, Modic M, Bruening R (eds) Multislice CT. Springer, Berlin, pp 109–117 Katada K, Fujii N, Ogura Y, Hayakawa M, Koga S (2001) Usefulness of isotropic volumetric data in neuroradiological diagnosis. In: Reiser MF, Takahashi M, Modic M, Bruening R (eds) Multislice CT. Springer, Berlin, pp 109–117
32.
Zurück zum Zitat Lammentausta E, Kiviranta P, Töyräs J, Hyttinen MM, Kiviranta I, Nieminen MT, Jurvelin JS (2007) Quantitative MRI of parallel changes of articular cartilage and underlying trabecular bone in degeneration. Osteoarthr Cartil 15:1149–1157PubMedCrossRef Lammentausta E, Kiviranta P, Töyräs J, Hyttinen MM, Kiviranta I, Nieminen MT, Jurvelin JS (2007) Quantitative MRI of parallel changes of articular cartilage and underlying trabecular bone in degeneration. Osteoarthr Cartil 15:1149–1157PubMedCrossRef
34.
Zurück zum Zitat Gong JK, Burgess E, Bacalao P (1966) Accretion and exchange of strontium-85 in trabecular and cortical bones. Radiat Res 28:753–765PubMedCrossRef Gong JK, Burgess E, Bacalao P (1966) Accretion and exchange of strontium-85 in trabecular and cortical bones. Radiat Res 28:753–765PubMedCrossRef
35.
Zurück zum Zitat Boyd SK, Matyas JR, Wohl GR, Kantzas A, Zernicke RF (2000) Early reginoal adaptation of periarticular bone mineral density after anterior cruciate ligament injury. J Appl Physiol 89:2359–2364PubMed Boyd SK, Matyas JR, Wohl GR, Kantzas A, Zernicke RF (2000) Early reginoal adaptation of periarticular bone mineral density after anterior cruciate ligament injury. J Appl Physiol 89:2359–2364PubMed
36.
Zurück zum Zitat Altman RD, Hochberg M, Murphy WA, Murphy WA Jr, Wolfe F, Lequesne M (1995) Atlas of individual radiographic features in osteoarthritis. Osteoarthr Cartil 3(Suppl A):3–70PubMed Altman RD, Hochberg M, Murphy WA, Murphy WA Jr, Wolfe F, Lequesne M (1995) Atlas of individual radiographic features in osteoarthritis. Osteoarthr Cartil 3(Suppl A):3–70PubMed
Metadaten
Titel
Regional depth-specific subchondral bone density measures in osteoarthritic and normal patellae: in vivo precision and preliminary comparisons
verfasst von
W. D. Burnett
S. A. Kontulainen
C. E. McLennan
D. J. Hunter
D. R. Wilson
J. D. Johnston
Publikationsdatum
01.03.2014
Verlag
Springer London
Erschienen in
Osteoporosis International / Ausgabe 3/2014
Print ISSN: 0937-941X
Elektronische ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-013-2568-2

Weitere Artikel der Ausgabe 3/2014

Osteoporosis International 3/2014 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Proximale Humerusfraktur: Auch 100-Jährige operieren?

01.05.2024 DCK 2024 Kongressbericht

Mit dem demographischen Wandel versorgt auch die Chirurgie immer mehr betagte Menschen. Von Entwicklungen wie Fast-Track können auch ältere Menschen profitieren und bei proximaler Humerusfraktur können selbst manche 100-Jährige noch sicher operiert werden.

Sind Frauen die fähigeren Ärzte?

30.04.2024 Gendermedizin Nachrichten

Patienten, die von Ärztinnen behandelt werden, dürfen offenbar auf bessere Therapieergebnisse hoffen als Patienten von Ärzten. Besonders gilt das offenbar für weibliche Kranke, wie eine Studie zeigt.

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Arthroskopie kann Knieprothese nicht hinauszögern

25.04.2024 Gonarthrose Nachrichten

Ein arthroskopischer Eingriff bei Kniearthrose macht im Hinblick darauf, ob und wann ein Gelenkersatz fällig wird, offenbar keinen Unterschied.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.