1
|
Guo J, Yan P, Qin Y, Liu M, Ma Y, Li J, Wang R, Luo H, Lv S. Automated measurement and grading of knee cartilage thickness: a deep learning-based approach. Front Med (Lausanne) 2024; 11:1337993. [PMID: 38487024 PMCID: PMC10939064 DOI: 10.3389/fmed.2024.1337993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 02/05/2024] [Indexed: 03/17/2024] Open
Abstract
Background Knee cartilage is the most crucial structure in the knee, and the reduction of cartilage thickness is a significant factor in the occurrence and development of osteoarthritis. Measuring cartilage thickness allows for a more accurate assessment of cartilage wear, but this process is relatively time-consuming. Our objectives encompass using various DL methods to segment knee cartilage from MRIs taken with different equipment and parameters, building a DL-based model for measuring and grading knee cartilage, and establishing a standardized database of knee cartilage thickness. Methods In this retrospective study, we selected a mixed knee MRI dataset consisting of 700 cases from four datasets with varying cartilage thickness. We employed four convolutional neural networks-UNet, UNet++, ResUNet, and TransUNet-to train and segment the mixed dataset, leveraging an extensive array of labeled data for effective supervised learning. Subsequently, we measured and graded the thickness of knee cartilage in 12 regions. Finally, a standard knee cartilage thickness dataset was established using 291 cases with ages ranging from 20 to 45 years and a Kellgren-Lawrence grading of 0. Results The validation results of network segmentation showed that TransUNet performed the best in the mixed dataset, with an overall dice similarity coefficient of 0.813 and an Intersection over Union of 0.692. The model's mean absolute percentage error for automatic measurement and grading after segmentation was 0.831. The experiment also yielded standard knee cartilage thickness, with an average thickness of 1.98 mm for the femoral cartilage and 2.14 mm for the tibial cartilage. Conclusion By selecting the best knee cartilage segmentation network, we built a model with a stronger generalization ability to automatically segment, measure, and grade cartilage thickness. This model can assist surgeons in more accurately and efficiently diagnosing changes in patients' cartilage thickness.
Collapse
Affiliation(s)
- JaingRaong Guo
- Department of Orthopedics and Sports Medicine, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Pengfei Yan
- Department of Control Science and Engineering, Harbin Institute of Technology, Harbin, Heilongjiang, China
| | - Yong Qin
- Department of Orthopedics and Sports Medicine, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - MeiNa Liu
- Department of Biostatistics, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Yingkai Ma
- Department of Orthopedics and Sports Medicine, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - JaingQi Li
- Department of Control Science and Engineering, Harbin Institute of Technology, Harbin, Heilongjiang, China
| | - Ren Wang
- Department of Orthopedics and Sports Medicine, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Hao Luo
- Department of Control Science and Engineering, Harbin Institute of Technology, Harbin, Heilongjiang, China
| | - Songcen Lv
- Department of Orthopedics and Sports Medicine, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| |
Collapse
|
2
|
Hada S, Kaneko H, Liu L, Aoki T, Takamura T, Kinoshita M, Arita H, Shiozawa J, Negishi Y, Momoeda M, Kubota M, Aoki S, Okada Y, Ishijima M. Medial meniscus extrusion is directly correlated with medial tibial osteophyte in patients received reconstruction surgery for anterior cruciate ligament injury: A longitudinal study. OSTEOARTHRITIS AND CARTILAGE OPEN 2022; 4:100320. [DOI: 10.1016/j.ocarto.2022.100320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 10/16/2022] [Accepted: 11/07/2022] [Indexed: 11/21/2022] Open
|
3
|
Osteoarthritis: New Insight on Its Pathophysiology. J Clin Med 2022; 11:jcm11206013. [PMID: 36294334 PMCID: PMC9604603 DOI: 10.3390/jcm11206013] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/19/2022] [Accepted: 10/08/2022] [Indexed: 11/17/2022] Open
Abstract
Understanding of the basis of osteoarthritis (OA) has seen some interesting advancements in recent years. It has been observed that cartilage degeneration is preceded by subchondral bone lesions, suggesting a key role of this mechanism within the pathogenesis and progression of OA, as well as the formation of ectopic bone and osteophytes. Moreover, low-grade, chronic inflammation of the synovial lining has gained a central role in the definition of OA physiopathology, and central immunological mechanisms, innate but also adaptive, are now considered crucial in driving inflammation and tissue destruction. In addition, the role of neuroinflammation and central sensitization mechanisms as underlying causes of pain chronicity has been characterized. This has led to a renewed definition of OA, which is now intended as a complex multifactorial joint pathology caused by inflammatory and metabolic factors underlying joint damage. Since this evidence can directly affect the definition of the correct therapeutic approach to OA, an improved understanding of these pathophysiological mechanisms is fundamental. To this aim, this review provides an overview of the most updated evidence on OA pathogenesis; it presents the most recent insights on the pathophysiology of OA, describing the interplay between immunological and biochemical mechanisms proposed to drive inflammation and tissue destruction, as well as central sensitization mechanisms. Moreover, although the therapeutic implications consequent to the renewed definition of OA are beyond this review scope, some suggestions for intervention have been addressed.
Collapse
|
4
|
Microstructural and histomorphological features of osteophytes in late-stage human knee osteoarthritis with varus deformity. Joint Bone Spine 2022; 89:105353. [DOI: 10.1016/j.jbspin.2022.105353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 12/30/2021] [Accepted: 01/18/2022] [Indexed: 11/19/2022]
|
5
|
Duan A, Ma Z, Liu W, Shen K, Zhou H, Wang S, Kong R, Shao Y, Chen Y, Guo W, Liu F. 1,25-Dihydroxyvitamin D Inhibits Osteoarthritis by Modulating Interaction Between Vitamin D Receptor and NLRP3 in Macrophages. J Inflamm Res 2021; 14:6523-6542. [PMID: 34887675 PMCID: PMC8651053 DOI: 10.2147/jir.s339670] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 11/23/2021] [Indexed: 12/25/2022] Open
Abstract
Background Osteoarthritis (OA) is the most prevalent chronic joint disease globally. Loss of extracellular matrix (ECM) by chondrocytes is a classic feature of OA. Inflammatory cytokines, such as interleukin-1β (IL-1β) and interleukin-18 (IL-18), secreted mainly by macrophages, promote expression of matrix degrading proteins and further aggravate progression of OA. 1,25-dihydroxyvitamin D (1,25VD) modulates inflammation thus exerting protective effects on cartilage tissue. However, the underlying mechanisms of 1,25VD activity have not been fully elucidated. Methods The destabilization of the medial meniscus (DMM)-induced mice model of OA was established to investigate the protective effects of 1,25VD by micro-CT and Safranin-O and Fast Green staining. And the co-culture system between THP-1 cells and primary chondrocytes was constructed to explore the effects of vitamin D receptor (VDR) and 1,25VD on chondrogenic proliferation, apoptosis, and migration. The immunofluorescence staining and Western blot analysis were used to detect the expressions of ECM proteins and matrix degradation-associated proteases. Enzyme-linked immunosorbent assay (ELISA) was used to examine the expression levels of inflammatory cytokines. Results The findings of the study showed that 1,25VD prevented cartilage degeneration and osteophyte formation by inhibiting secretion of inflammatory cytokines in OA mice model. These protective effects were exerted through the vitamin D receptor (VDR). Further studies showed that 1,25VD increased ubiquitination level of NLRP3 by binding to VDR, resulting in decrease in IL-1β and IL-18 secretion. These findings indicate that 1,25VD binds to VDR thus preventing chondrogenic ECM degradation by modulating macrophage NLRP3 activation and secretion of inflammatory cytokines, thus alleviating OA progression. Conclusion Here, our study suggests that 1,25VD, targeting to VDR, prevents chondrogenic ECM degradation through regulating macrophage NLRP3 activation and inflammatory cytokines secretion, thereby alleviating OA. These findings provide information on a novel molecular mechanism for application of 1,25VD as OA therapy.
Collapse
Affiliation(s)
- Ao Duan
- Department of Orthopedics, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, Jiangsu, People's Republic of China
| | - Zemeng Ma
- Key Laboratory of Immune Microenvironment and Disease, Department of Immunology, Nanjing Medical University, Nanjing, 211100, People's Republic of China
| | - Wanshun Liu
- Department of Orthopedics, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, Jiangsu, People's Republic of China
| | - Kai Shen
- Department of Orthopedics, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, Jiangsu, People's Republic of China
| | - Hao Zhou
- Department of Orthopedics, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, Jiangsu, People's Republic of China
| | - Shunbing Wang
- Department of Rheumatology and Immunology, Affiliated Hospital of Hospital of North Sichuan Medical College, Nanchong, 637000, People's Republic of China
| | - Renyi Kong
- Department of Orthopedics, Xincheng Hospital of Traditional Chinese Medicine, Maanshan, 243131, Anhui, People's Republic of China
| | - Yuqi Shao
- Department of Orthopedics, The Second Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221006, Jiangsu, People's Republic of China
| | - Yunzi Chen
- Key Laboratory of Immune Microenvironment and Disease, Department of Immunology, Nanjing Medical University, Nanjing, 211100, People's Republic of China
| | - Wei Guo
- Department of Urology, The Affiliated Wuxi No.2 People's Hospital of Nanjing Medical University, Wuxi, 214002, Jiangsu, People's Republic of China
| | - Feng Liu
- Department of Orthopedics, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, Jiangsu, People's Republic of China
| |
Collapse
|
6
|
Arita H, Kaneko H, Ishibashi M, Sadatsuki R, Liu L, Hada S, Kinoshita M, Aoki T, Negishi Y, Momoeda M, Adili A, Kubota M, Okada Y, Kaneko K, Ishijima M. Medial meniscus extrusion is a determinant factor for the gait speed among MRI-detected structural alterations of knee osteoarthritis. OSTEOARTHRITIS AND CARTILAGE OPEN 2021; 3:100176. [DOI: 10.1016/j.ocarto.2021.100176] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 05/08/2021] [Accepted: 05/11/2021] [Indexed: 12/29/2022] Open
|
7
|
Okumura N, Kawasaki T, Kubo M, Yayama T, Mimura T, Kumagai K, Maeda T, Imai S. Effects of malalignment and disease activity on osteophyte formation in knees of rheumatoid arthritis patients. J Orthop Surg (Hong Kong) 2020; 28:2309499020911852. [PMID: 32223493 DOI: 10.1177/2309499020911852] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
PURPOSE Rheumatoid arthritis (RA) patients with secondary osteoarthritis (OA) in a knee joint following a total knee arthroplasty (TKA) procedure have been increasing. Here, we investigated osteophyte formation in knee joints of RA patients and associated factors. METHODS We retrospectively examined findings of 35 knees in 30 RA patients (26 females, 4 males; mean age: 63.0 years; median disease duration: 15 years) who underwent TKA, including preoperative anteroposterior view radiographs of the knee joint. Using the ImageJ software package, osteophyte size in the medial femur (MF), medial tibia (MT), lateral femur (LF), and lateral tibia (LT) regions was also determined. RESULTS The mean femorotibial angle was 179°, while Larsen grade was 2 in 1, 3 in 12, 4 in 18, and 5 in 2 patients. Osteophyte sizes in the MF, MT, LF, and LT regions were 37.2, 17.0, 27.2, and 4.57 mm2, respectively, and significantly greater in the medial compartment (MC; MF+MT) than the lateral compartment (LC; LF+LT) (p < 0.001). In varus cases, osteophyte size in the MC was significantly larger than normal and valgus cases (p = 0.0016). Furthermore, osteophyte size in the MC was negatively correlated with the inflammatory markers C-reactive protein (r = -0.492, p = 0.0027) and erythrocyte sedimentation rate (r = -0.529, p = 0.0016), whereas that in the LC was negatively correlated with disease activity (r = -0.589, p = 0.0023). CONCLUSION Our results suggest that alignment and disease activity influence osteophyte formation in RA patients, with secondary OA a more prominent symptom in RA patients with controlled inflammation.
Collapse
Affiliation(s)
- Noriaki Okumura
- Department of Orthopedic Surgery, Kyoto Okamoto Memorial Hospital, Kyoto, Japan.,Department of Orthopedic Surgery, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Taku Kawasaki
- Department of Orthopedic Surgery, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Mitsuhiko Kubo
- Department of Orthopedic Surgery, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Takafumi Yayama
- Department of Orthopedic Surgery, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Tomohiro Mimura
- Department of Orthopedic Surgery, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Kosuke Kumagai
- Department of Orthopedic Surgery, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Tsutomu Maeda
- Department of Orthopedic Surgery, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Shinji Imai
- Department of Orthopedic Surgery, Shiga University of Medical Science, Otsu, Shiga, Japan
| |
Collapse
|
8
|
Periarticular osteophyte formation protects against total knee arthroplasty in rheumatoid arthritis patients with advanced joint damage. Clin Rheumatol 2020; 39:3331-3339. [DOI: 10.1007/s10067-020-05140-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 04/10/2020] [Accepted: 05/01/2020] [Indexed: 02/07/2023]
|
9
|
Someya Y, Tamura Y, Kaga H, Nojiri S, Shimada K, Daida H, Ishijima M, Kaneko K, Aoki S, Miida T, Hirayama S, Konishi S, Hattori N, Motoi Y, Naito H, Kawamori R, Watada H. Skeletal muscle function and need for long-term care of urban elderly people in Japan (the Bunkyo Health Study): a prospective cohort study. BMJ Open 2019; 9:e031584. [PMID: 31530621 PMCID: PMC6756356 DOI: 10.1136/bmjopen-2019-031584] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
PURPOSE The proportion of elderly individuals (age ≥65 years) in Japan reached 27.7% in 2017, the highest in the world. A serious social problem in a super-aged society is the rise in the number of elderly people who need long-term care (LTC), which is mainly due to cerebrovascular disease, dementia, age-related frailty, falls and fractures, and joint disease. We hypothesised that decreased muscle mass, muscle strength and insulin sensitivity are the common risk factors for these diseases related to needing LTC. We developed a prospective cohort study of elderly subjects in an urban community to test this hypothesis. The primary objective is to prospectively investigate associations between muscle mass, muscle strength, and insulin sensitivity and incidence of main disease and risk factors of needing LTC. The primary outcomes are the incidence of cerebrovascular disease and cognitive decline. PARTICIPANTS Participants were 1629 people aged 65-84 years living in 13 communities in an urban area (Bunkyo-ku, Tokyo, Japan). Average age was 73.1±5.4 years. FINDINGS TO DATE We obtained baseline data on cognitive function, cerebral small vessel disease (SVD) determined by brain MRI, body composition, bone mineral density, arteriosclerosis, physical function, muscle mass, muscle strength and insulin sensitivity. Mild cognitive impairment and dementia were observed in 18.1% and 3.3% of participants, respectively. The prevalence of cerebral SVD was 24.8%. These characteristics are similar to those previously reported in elderly Japanese subjects. FUTURE PLANS We will ask participants about their health status, including incidence of cerebrovascular disease, falls, fractures and other diseases every year by mail. We plan to re-evaluate cognitive function, brain MRI parameters and other parameters at 5 and 10 years after the baseline evaluation. We will evaluate whether low muscle function (muscle mass, muscle strength or insulin sensitivity) is a risk factor for cognitive decline or cerebrovascular disease.
Collapse
Affiliation(s)
- Yuki Someya
- Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Juntendo University Graduate School of Health and Sports Science, Chiba, Japan
| | - Yoshifumi Tamura
- Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Hideyoshi Kaga
- Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Shuko Nojiri
- Clinical Research Support Center, Juntendo University, Tokyo, Japan
| | - Kazunori Shimada
- Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Hiroyuki Daida
- Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Muneaki Ishijima
- Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Medicine for Orthtopaedics and Motor Organ, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Kazuo Kaneko
- Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Medicine for Orthtopaedics and Motor Organ, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Shigeki Aoki
- Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Takashi Miida
- Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Clinical Laboratory Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Satoshi Hirayama
- Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Clinical Laboratory Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Seiki Konishi
- Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Clinical Laboratory Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Nobutaka Hattori
- Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Neurology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yumiko Motoi
- Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Diagnosis, Prevention and Treatment of Dementia, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Hisashi Naito
- Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Juntendo University Graduate School of Health and Sports Science, Chiba, Japan
| | - Ryuzo Kawamori
- Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Hirotaka Watada
- Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| |
Collapse
|
10
|
MRI-detected osteophytes of the knee: natural history and structural correlates of change. Arthritis Res Ther 2018; 20:237. [PMID: 30352619 PMCID: PMC6235223 DOI: 10.1186/s13075-018-1734-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Accepted: 09/25/2018] [Indexed: 01/08/2023] Open
Abstract
Backgroud The natural history of semi-quantitative magnetic resonance imaging (MRI)-detected osteophytes (MRI-detected OPs) has not been described and it is unknown whether knee structural abnormalities can predict MRI-detected OP change over time. Thus, the aim of current study is to describe the natural history of knee MRI-detected OP, and to determine if knee structural abnormalities are associated with change of MRI-detected OP in a longitudinal study of older adults. Methods Randomly selected older adults (n = 837, mean age 63 years) had MRI at baseline and 413 of them had MRI 2.6 years later to measure MRI-detected OP, cartilage defects, cartilage volume, bone marrow lesions (BMLs), meniscal extrusion, infrapatellar fat pad (IPFP) quality score/maximum area and effusion-synovitis. Results Over 2.6 years, average MRI-detected OP score increased significantly in all compartments. The total MRI-detected OP score remained stable in 53% of participants, worsened (≥ 1-point increase) in 46% and decreased in 1%. Baseline cartilage defects (RR, 1.25–1.35), BMLs (RR, 1.16–1.17), meniscal extrusion (RR, 1.22–1.33) and IPFP quality score (RR, 1.08–1.20) site-specifically and independently predicted an increase in MRI-detected OP (p values all ≤ 0.05), after adjustment for covariates. Presence of IPFP abnormality was significantly associated with increased MRI-detected OPs but became non-significant after adjustment for other structural abnormalities. Total (RR, 1.27) and suprapatellar pouch effusion-synovitis (RR, 1.22) were both associated with increased MRI-detected OPs in the lateral compartment only (both p < 0.04). Conclusion Knee MRI-detected OPs are common in older adults and are likely to progress. The association between baseline structural abnormalities and worsening MRI-detected OPs suggest MRI-detected OP could be a consequence of multiple knee structural abnormalities.
Collapse
|