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Pishgar F, Ashraf-ganjouei A, Dolatshahi M, Guermazi A, Zikria B, Cao X, Wan M, Roemer FW, Dam E, Demehri S. Conventional MRI-derived subchondral trabecular biomarkers and their association with knee cartilage volume loss as early as 1 year: a longitudinal analysis from Osteoarthritis Initiative. Skeletal Radiol 2022; 51:1959-1966. [PMID: 35366094 PMCID: PMC9414671 DOI: 10.1007/s00256-022-04042-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 02/13/2022] [Accepted: 02/13/2022] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To study associations between MRI-derived subchondral trabecular biomarkers obtained from conventional MRI sequences and knee cartilage loss over 12 and 24 months, using the FNIH osteoarthritis (OA) biomarkers consortium. MATERIALS AND METHODS Data of the 600 subjects in the FNIH OA biomarkers consortium (a nested case-control study within Osteoarthritis Initiative [OAI]) were extracted from the online database. Baseline knee MRI (intermediate-weighted (IW) sequences) were evaluated to determine conventional MRI-derived trabecular thickness (cTbTh) and bone-to-total ratio (cBV/TV). The measurements for medial and lateral volumes of cartilages using baseline, 12-, and 24-month knee MRI were extracted from the OAI database, and cartilage volume loss over 12 and 24 months of follow-up were determined using Relative Change Index. The association between conventional MRI-based subchondral trabecular biomarkers and cartilage volume loss were studied using logistic regression models, adjusted for relevant confounders including age, sex, body mass index (BMI), vitamin D use, Kellgren Lawrence grade (KLG), and tibiofemoral alignment. RESULTS Higher medial cTbTh and cBV/TV at baseline were associated with increased odds of medial tibial cartilage volume loss over 12 months (ORs: 1.01 [1.00-1.02] and 1.24 [1.10-1.39] per 1-SD change) and 24 months (ORs: 1.01 [1.00-1.02] and 1.22 [1.08-1.37], per 1-SD change). No significant association was observed between medial subchondral trabecular biomarkers and lateral tibial or femoral (medial or lateral) cartilage volume loss over the first and second follow-up years. CONCLUSIONS Conventional MRI-derived subchondral trabecular biomarkers (higher medial cTbTh and cBV/TV) may be associated with increased medial tibial cartilage volume loss as early as 1 year.
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Affiliation(s)
- Farhad Pishgar
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 4240, Baltimore, MD 21287, USA
| | - Amir Ashraf-ganjouei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Science Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahsa Dolatshahi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Guermazi
- Department of Radiology, VA Boston Healthcare System, Boston University School of Medicine, Boston, MA, USA
| | - Bashir Zikria
- Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Xu Cao
- Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Mei Wan
- Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Frank W. Roemer
- Department of Radiology, VA Boston Healthcare System, Boston University School of Medicine, Boston, MA, USA,Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Erik Dam
- Machine Learning Section, Department of Computer Science, University of Copenhagen, Kobenhavns, Denmark
| | - Shadpour Demehri
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 4240, Baltimore, MD 21287, USA
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Almhdie-Imjabbar A, Podsiadlo P, Ljuhar R, Jennane R, Nguyen KL, Toumi H, Saarakkala S, Lespessailles E. Trabecular bone texture analysis of conventional radiographs in the assessment of knee osteoarthritis: review and viewpoint. Arthritis Res Ther 2021; 23:208. [PMID: 34362427 PMCID: PMC8344203 DOI: 10.1186/s13075-021-02594-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 07/28/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Trabecular bone texture analysis (TBTA) has been identified as an imaging biomarker that provides information on trabecular bone changes due to knee osteoarthritis (KOA). Consequently, it is important to conduct a comprehensive review that would permit a better understanding of this unfamiliar image analysis technique in the area of KOA research. We examined how TBTA, conducted on knee radiographs, is associated to (i) KOA incidence and progression, (ii) total knee arthroplasty, and (iii) KOA treatment responses. The primary aims of this study are twofold: to provide (i) a narrative review of the studies conducted on radiographic KOA using TBTA, and (ii) a viewpoint on future research priorities. METHOD Literature searches were performed in the PubMed electronic database. Studies published between June 1991 and March 2020 and related to traditional and fractal image analysis of trabecular bone texture (TBT) on knee radiographs were identified. RESULTS The search resulted in 219 papers. After title and abstract scanning, 39 studies were found eligible and then classified in accordance to six criteria: cross-sectional evaluation of osteoarthritis and non-osteoarthritis knees, understanding of bone microarchitecture, prediction of KOA progression, KOA incidence, and total knee arthroplasty and association with treatment response. Numerous studies have reported the relevance of TBTA as a potential bioimaging marker in the prediction of KOA incidence and progression. However, only a few studies have focused on the association of TBTA with both OA treatment responses and the prediction of knee joint replacement. CONCLUSION Clear evidence of biological plausibility for TBTA in KOA is already established. The review confirms the consistent association between TBT and important KOA endpoints such as KOA radiographic incidence and progression. TBTA could provide markers for enrichment of clinical trials enhancing the screening of KOA progressors. Major advances were made towards a fully automated assessment of KOA.
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Affiliation(s)
- Ahmad Almhdie-Imjabbar
- EA 4708- I3MTO Laboratory, University of Orleans, Orleans, France
- Translational Medicine Research Platform, PRIMMO, Regional Hospital of Orleans, Orleans, France
| | - Pawel Podsiadlo
- Tribology Laboratory, School of Civil and Mechanical Engineering, Curtin University, Bentley, WA, 6102, Australia
| | | | - Rachid Jennane
- EA 4708- I3MTO Laboratory, University of Orleans, Orleans, France
- Translational Medicine Research Platform, PRIMMO, Regional Hospital of Orleans, Orleans, France
| | - Khac-Lan Nguyen
- EA 4708- I3MTO Laboratory, University of Orleans, Orleans, France
- Translational Medicine Research Platform, PRIMMO, Regional Hospital of Orleans, Orleans, France
| | - Hechmi Toumi
- EA 4708- I3MTO Laboratory, University of Orleans, Orleans, France
- Translational Medicine Research Platform, PRIMMO, Regional Hospital of Orleans, Orleans, France
- Department of Rheumatology, Regional Hospital of Orleans, Orleans, France
| | - Simo Saarakkala
- Physics and Technology, Research Unit of Medical Imaging, University of Oulu, Oulu, Finland
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
| | - Eric Lespessailles
- EA 4708- I3MTO Laboratory, University of Orleans, Orleans, France.
- Translational Medicine Research Platform, PRIMMO, Regional Hospital of Orleans, Orleans, France.
- Department of Rheumatology, Regional Hospital of Orleans, Orleans, France.
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Freiberg A, Bolm-Audorff U, Seidler A. The Risk of Knee Osteoarthritis in Professional Soccer Players. Dtsch Arztebl Int 2021; 118:49-55. [PMID: 33759745 DOI: 10.3238/arztebl.m2021.0007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 02/26/2020] [Accepted: 08/24/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND We address the question whether professional soccer players with and without macroinjury of the knee joint are at an elevated risk for knee osteoarthritis. METHODS A systematic review with meta-analyses was conducted. The study protocol was prospectively registered (registration number CRD42019137139). The MEDLINE, EMBASE, and Web of Science databases were searched for relevant publications; in addition, forward searching was performed, and the listed references were considered. All steps of the process were undertaken independently by two reviewers, and any discordances were resolved by consensus. For all publications whose full text was included, the methods used were critically evaluated. The quality of the evidence was judged using the GRADE criteria. RESULTS The pooled odds ratio for objectively ascertained osteoarthrosis of the knee was 2.25 (95% confidence interval [1.41-3.61], I2 = 71%). When only radiologically ascertained knee osteoarthrosis was considered, the odds ratio was 3.98 [1.34; 11.83], I2 = 58%). The pooled risk estimator in studies in which knee joint macroinjury was excluded was 2.81 ([1.25; 6.32], I2 = 71%). CONCLUSION A marked association was found between soccer playing and knee osteoarthritis in male professional soccer players. For female professional soccer players, the risk of knee osteoarthritis could not be assessed because of the lack of data. Knee injuries seem to play an important role in the development of knee osteoarthritis in professional soccer players.
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Affiliation(s)
- Alice Freiberg
- Institute and Policlinic of Occupational and Social Medicine, Medical Faculty Carl Gustav Carus, Technische Universität Dresden; Division of Occupational Health, Department of Occupational Safety and Environment, Regional Government of South Hesse, Wiesbaden; Extraordinary Chair of Occupational Medicine, University of Gießen
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Wang C, Brisson BK, Terajima M, Li Q, Hoxha K, Han B, Goldberg AM, Sherry Liu X, Marcolongo MS, Enomoto-Iwamoto M, Yamauchi M, Volk SW, Han L. Type III collagen is a key regulator of the collagen fibrillar structure and biomechanics of articular cartilage and meniscus. Matrix Biol 2019; 85-86:47-67. [PMID: 31655293 DOI: 10.1016/j.matbio.2019.10.001] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 10/15/2019] [Accepted: 10/16/2019] [Indexed: 02/07/2023]
Abstract
Despite the fact that type III collagen is the second most abundant collagen type in the body, its contribution to the physiologic maintenance and repair of skeletal tissues remains poorly understood. This study queried the role of type III collagen in the structure and biomechanical functions of two structurally distinctive tissues in the knee joint, type II collagen-rich articular cartilage and type I collagen-dominated meniscus. Integrating outcomes from atomic force microscopy-based nanomechanical tests, collagen fibril nanostructural analysis, collagen cross-link analysis and histology, we elucidated the impact of type III collagen haplodeficiency on the morphology, nanostructure and biomechanical properties of articular cartilage and meniscus in Col3a1+/- mice. Reduction of type III collagen leads to increased heterogeneity and mean thickness of collagen fibril diameter, as well as reduced modulus in both tissues, and these effects became more pronounced with skeletal maturation. These data suggest a crucial role of type III collagen in mediating fibril assembly and biomechanical functions of both articular cartilage and meniscus during post-natal growth. In articular cartilage, type III collagen has a marked contribution to the micromechanics of the pericellular matrix, indicating a potential role in mediating the early stage of type II collagen fibrillogenesis and chondrocyte mechanotransduction. In both tissues, reduction of type III collagen leads to decrease in tissue modulus despite the increase in collagen cross-linking. This suggests that the disruption of matrix structure due to type III collagen deficiency outweighs the stiffening of collagen fibrils by increased cross-linking, leading to a net negative impact on tissue modulus. Collectively, this study is the first to highlight the crucial structural role of type III collagen in both articular cartilage and meniscus extracellular matrices. We expect these results to expand our understanding of type III collagen across various tissue types, and to uncover critical molecular components of the microniche for regenerative strategies targeting articular cartilage and meniscus repair.
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Affiliation(s)
- Chao Wang
- School of Biomedical Engineering, Science and Health Systems, Drexel University, Philadelphia, PA 19104, United States
| | - Becky K Brisson
- Department of Clinical Sciences and Advanced Medicine, University of Pennsylvania, School of Veterinary Medicine, Philadelphia, PA, 19104, United States
| | - Masahiko Terajima
- Division of Oral and Craniofacial Health Sciences, University of North Carolina, Chapel Hill, NC, 27599, United States
| | - Qing Li
- School of Biomedical Engineering, Science and Health Systems, Drexel University, Philadelphia, PA 19104, United States
| | - Kevt'her Hoxha
- School of Biomedical Engineering, Science and Health Systems, Drexel University, Philadelphia, PA 19104, United States
| | - Biao Han
- School of Biomedical Engineering, Science and Health Systems, Drexel University, Philadelphia, PA 19104, United States
| | - Abby M Goldberg
- Department of Clinical Sciences and Advanced Medicine, University of Pennsylvania, School of Veterinary Medicine, Philadelphia, PA, 19104, United States
| | - X Sherry Liu
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, United States
| | - Michele S Marcolongo
- Department of Materials Science and Engineering, Drexel University, Philadelphia, PA, 19104, United States
| | - Motomi Enomoto-Iwamoto
- Department of Orthopaedics, School of Medicine, University of Maryland, Baltimore, MD, 21201, United States
| | - Mitsuo Yamauchi
- Division of Oral and Craniofacial Health Sciences, University of North Carolina, Chapel Hill, NC, 27599, United States
| | - Susan W Volk
- Department of Clinical Sciences and Advanced Medicine, University of Pennsylvania, School of Veterinary Medicine, Philadelphia, PA, 19104, United States.
| | - Lin Han
- School of Biomedical Engineering, Science and Health Systems, Drexel University, Philadelphia, PA 19104, United States.
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Birch CE, Mensch KS, Desarno MJ, Beynnon BD, Tourville TW. Subchondral trabecular bone integrity changes following ACL injury and reconstruction: a cohort study with a nested, matched case-control analysis. Osteoarthritis Cartilage 2018; 26:762-769. [PMID: 29572129 PMCID: PMC5962427 DOI: 10.1016/j.joca.2018.02.905] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 01/31/2018] [Accepted: 02/27/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE There is limited information regarding changes in bone architecture following anterior cruciate ligament (ACL) injury. The objective of this study was to evaluate differences in tibial fractal signature in the medial and lateral compartments following ACL injury and describe how these values change following ACL-reconstruction and return to activity. DESIGN This was a prospective cohort study with a nested case-control analysis. ACL-injured subjects and matched controls were evaluated at pre-surgical baseline and post ACL reconstruction follow-up at a mean of 46 months. Serial Fractal Dimensions (FD) of tibial subchondral bone architecture were calculated in medial and lateral regions of interest in the horizontal and vertical dimensions. RESULTS In the medial and lateral compartments, there were significant differences in the vertical FD signature for ACL-injured subjects at final follow-up, when compared to the contralateral healthy tibia (medial P < 0.0001; lateral P < 0.0001) and the control group (medial P = 0.01; lateral P < 0.0001). Similarly, in the lateral compartment, there were significant differences in the horizontal FD profile for ACL-injured subjects at final follow-up, when compared to the contralateral healthy tibia (P = 0.003) and the controls (P < 0.0001). There were no significant side-to-side differences in FDs among healthy control subjects in the medial or lateral compartments at baseline or final follow-up. CONCLUSION At 46-month follow-up, FD profiles are significantly different, and show an overall lower FD signature, for ACL-injured knees when compared to the contralateral healthy knee and uninjured controls. Additionally, this study provided the first side-to-side symmetry data of medial and lateral FD values in healthy controls.
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Affiliation(s)
- C E Birch
- University of Vermont, Department of Orthopaedics and Rehabilitation, San Antonio, TX, USA.
| | - K S Mensch
- University of Texas Health Science Center at San Antonio, Department of Orthopaedics, Burlington, VT, USA.
| | - M J Desarno
- University of Vermont, Department of Medical Biostatistics, Burlington, VT, USA.
| | - B D Beynnon
- University of Vermont, Department of Orthopaedics and Rehabilitation, San Antonio, TX, USA.
| | - T W Tourville
- University of Vermont, Department of Orthopaedics and Rehabilitation, San Antonio, TX, USA; University of Vermont, Department of Rehabilitation and Movement Science, Burlington, VT, USA.
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Hirvasniemi J, Thevenot J, Guermazi A, Podlipská J, Roemer FW, Nieminen MT, Saarakkala S. Differences in tibial subchondral bone structure evaluated using plain radiographs between knees with and without cartilage damage or bone marrow lesions - the Oulu Knee Osteoarthritis study. Eur Radiol 2017; 27:4874-4882. [PMID: 28439649 PMCID: PMC5635082 DOI: 10.1007/s00330-017-4826-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 03/13/2017] [Accepted: 03/20/2017] [Indexed: 11/28/2022]
Abstract
Objectives To investigate whether subchondral bone structure from plain radiographs is different between subjects with and without articular cartilage damage or bone marrow lesions (BMLs). Methods Radiography-based bone structure was assessed from 80 subjects with different stages of knee osteoarthritis using entropy of Laplacian-based image (ELap) and local binary patterns (ELBP), homogeneity index of local angles (HIAngles,mean), and horizontal (FDHor) and vertical fractal dimensions (FDVer). Medial tibial articular cartilage damage and BMLs were scored using the magnetic resonance imaging osteoarthritis knee score. Level of statistical significance was set to p < 0.05. Results Subjects with medial tibial cartilage damage had significantly higher FDVer and ELBP as well as lower ELap and HIAngles,mean in the medial tibial subchondral bone region than subjects without damage. FDHor, FDVer, and ELBP were significantly higher, whereas ELap and HIAngles,mean were lower in the medial trabecular bone region. Subjects with medial tibial BMLs had significantly higher FDVer and ELBP as well as lower ELap and HIAngles,mean in medial tibial subchondral bone. FDHor, FDVer, and ELBP were higher, whereas ELap and HIAngles,mean were lower in medial trabecular bone. Conclusions Our results support the use of bone structural analysis from radiographs when examining subjects with osteoarthritis or at risk of having it. Key points • Knee osteoarthritis causes changes in articular cartilage and subchondral bone • Magnetic resonance imaging is a comprehensive imaging modality for knee osteoarthritis • Radiography-based bone structure analysis can provide additional information of osteoarthritic subjects
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Affiliation(s)
- Jukka Hirvasniemi
- Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, POB 5000, FI-90014, Oulu, Finland. .,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.
| | - Jérôme Thevenot
- Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, POB 5000, FI-90014, Oulu, Finland.,Infotech Oulu, University of Oulu, Oulu, Finland
| | - Ali Guermazi
- Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, Boston, MA, USA
| | - Jana Podlipská
- Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, POB 5000, FI-90014, Oulu, Finland.,Infotech Oulu, University of Oulu, Oulu, Finland
| | - Frank W Roemer
- Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, Boston, MA, USA.,Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Miika T Nieminen
- Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, POB 5000, FI-90014, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Infotech Oulu, University of Oulu, Oulu, Finland.,Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
| | - Simo Saarakkala
- Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, POB 5000, FI-90014, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Infotech Oulu, University of Oulu, Oulu, Finland.,Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
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Boeth H, MacMahon A, Eckstein F, Diederichs G, Schlausch A, Wirth W, Duda GN. MRI findings of knee abnormalities in adolescent and adult volleyball players. J Exp Orthop 2017; 4:6. [PMID: 28224374 PMCID: PMC5319929 DOI: 10.1186/s40634-017-0080-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Accepted: 02/10/2017] [Indexed: 01/08/2023] Open
Abstract
Background To longitudinally and cross-sectionally evaluate knee abnormalities by sex and age in adolescent and adult volleyball athletes over 2 years using magnetic resonance imaging (MRI). Methods Thirty-six high-level volleyball athletes (18 adolescents: 56% female, mean age 16.0 ± 0.8 years; and 18 adults: 50% female, mean age 46.8 ± 5.1 years) were imaged by MRI at BL and at 2-year follow-up (FU). Prevalence and severity of cartilage lesions, subarticular bone marrow lesions (BMLs), subarticular cysts, osteophytes, and ligament and meniscus integrity were evaluated by sex and by age cohort (adolescents and adults) using the whole-organ MRI score (WORMS). Results There were no significant longitudinal changes in any of the features within any of the sex or age groups. No significant differences were found in overall prevalence or severity of any of the features between males and females, although at FU, males had a significantly higher prevalence of osteophytes in the medial femorotibial joint (MFTJ) than females (p=0.044). Compared to adolescents, adult volleyball players had a significantly greater prevalence and severity of cartilage lesions (p<0.001 for both), BMLs (p=0.0153 and p=0.005), and osteophytes (p≤0.003 and p<0.001), and more severe meniscal lesions (p≤0.021). Conclusion We found significant differences in the prevalence and severity of knee abnormalities between adolescent and adult volleyball players, but no overall differences by sex. These findings lay the groundwork for further investigations with larger cohorts and longer FU times to determine whether or not these knee abnormalities are associated with the development of OA.
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Affiliation(s)
- Heide Boeth
- Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Berlin, Germany.
| | - Aoife MacMahon
- Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Felix Eckstein
- Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Gerd Diederichs
- Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Arne Schlausch
- Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Wolfgang Wirth
- Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Georg N Duda
- Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Berlin, Germany
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Lowitz T, Museyko O, Bousson V, Chappard C, Laouisset L, Laredo JD, Engelke K. Advanced Knee Structure Analysis (AKSA): a comparison of bone mineral density and trabecular texture measurements using computed tomography and high-resolution peripheral quantitative computed tomography of human knee cadavers. Arthritis Res Ther 2017; 19:1. [PMID: 28073368 PMCID: PMC5223490 DOI: 10.1186/s13075-016-1210-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 12/13/2016] [Indexed: 12/21/2022] Open
Abstract
Background A change of loading conditions in the knee causes changes in the subchondral bone and may be a cause of osteoarthritis (OA). However, quantification of trabecular architecture in vivo is difficult due to the limiting spatial resolution of the imaging equipment; one approach is the use of texture parameters. In previous studies, we have used digital models to simulate changes of subchondral bone architecture under OA progression. One major result was that, using computed tomography (CT) images, subchondral bone mineral density (BMD) in combination with anisotropy and global homogeneity could characterize this progression. The primary goal of this study was a comparison of BMD, entropy, anisotropy, variogram slope, and local and global inhomogeneity measurements between high-resolution peripheral quantitative CT (HR-pQCT) and CT using human cadaveric knees. The secondary goal was the verification of the spatial resolution dependence of texture parameters observed in the earlier simulations, two important prerequisites for the interpretation of in vivo measurements in OA patients. Method The applicability of texture analysis to characterize bone architecture in clinical CT examinations was investigated and compared to results obtained from HR-pQCT. Fifty-seven human knee cadavers (OA status unknown) were examined with both imaging modalities. Three-dimensional (3D) segmentation and registration processes, together with automatic positioning of 3D analysis volumes of interest (VOIs), ensured the measurement of BMD and texture parameters at the same anatomical locations in CT and HR-pQCT datasets. Results According to the calculation of dice ratios (>0.978), the accuracy of VOI locations between methods was excellent. Entropy, anisotropy, and global inhomogeneity showed significant and high linear correlation between both methods (0.68 < R2 < 1.00). The resolution dependence of these parameters simulated earlier was confirmed by the in vitro measurements. Conclusion The high correlation of HR-pQCT- and CT-based measurements of entropy, global inhomogeneity, and anisotropy suggests interchangeability between devices regarding the quantification of texture. The agreement of the experimentally determined resolution dependence of global inhomogeneity and anisotropy with earlier simulations is an important milestone towards their use to quantify subchondral bone structure. However, an in vivo study is still required to establish their clinical relevance.
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Affiliation(s)
- Torsten Lowitz
- Institute of Medical Physics, University of Erlangen-Nürnberg, Henkestr. 91, 91052, Erlangen, Germany
| | - Oleg Museyko
- Institute of Medical Physics, University of Erlangen-Nürnberg, Henkestr. 91, 91052, Erlangen, Germany
| | - Valérie Bousson
- AP-HP, Hôpital Lariboisière, Service de Radiologie Ostéo-Articulaire, 2, rue Ambroise-Paré, F-75475, Paris, Cedex 10, France.,Univ. Paris Diderot, Sorbonne Paris Cité, Laboratoire B2OA, CNRS UMR 7052, 75010, Paris, France
| | - Christine Chappard
- AP-HP, Hôpital Lariboisière, Service de Radiologie Ostéo-Articulaire, 2, rue Ambroise-Paré, F-75475, Paris, Cedex 10, France.,Univ. Paris Diderot, Sorbonne Paris Cité, Laboratoire B2OA, CNRS UMR 7052, 75010, Paris, France
| | - Liess Laouisset
- AP-HP, Hôpital Lariboisière, Service de Radiologie Ostéo-Articulaire, 2, rue Ambroise-Paré, F-75475, Paris, Cedex 10, France.,Univ. Paris Diderot, Sorbonne Paris Cité, Laboratoire B2OA, CNRS UMR 7052, 75010, Paris, France
| | - Jean-Denis Laredo
- AP-HP, Hôpital Lariboisière, Service de Radiologie Ostéo-Articulaire, 2, rue Ambroise-Paré, F-75475, Paris, Cedex 10, France.,Univ. Paris Diderot, Sorbonne Paris Cité, Laboratoire B2OA, CNRS UMR 7052, 75010, Paris, France
| | - Klaus Engelke
- Institute of Medical Physics, University of Erlangen-Nürnberg, Henkestr. 91, 91052, Erlangen, Germany.
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Van Der Straeten C, Byttebier P, Eeckhoudt A, Victor J. Meniscal Allograft Transplantation Does Not Prevent or Delay Progression of Knee Osteoarthritis. PLoS One 2016; 11:e0156183. [PMID: 27228174 PMCID: PMC4881946 DOI: 10.1371/journal.pone.0156183] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 05/10/2016] [Indexed: 11/23/2022] Open
Abstract
Background Meniscal tears are common knee injuries. Meniscal allograft transplantation (MAT) has been advocated to alleviate symptoms and delay osteoarthritis (OA) after meniscectomy. We investigated (1) the long-term outcome of MAT as a treatment of symptomatic meniscectomy, (2) most important factors affecting survivorship and (3) OA progression. Methods From 1989 till 2013, 329 MAT were performed in 313 patients. Clinical and radiographic results and MAT survival were evaluated retrospectively. Failure was defined as conversion to knee arthroplasty (KA) or total removal of the MAT. Results Mean age at surgery was 33 years (15–57); 60% were males. No-to-mild cartilage damage was found in 156 cases, moderate-to-severe damage in 130. Simultaneous procedures in 118 patients included cartilage procedures, osteotomy or ACL-reconstruction. At a mean follow-up of 6.8 years (0.2–24.3years), 5 patients were deceased and 48 lost (14.6%), 186 MAT were in situ (56.5%) whilst 90 (27.4%) had been removed, including 63 converted to a KA (19.2%). Cumulative allograft survivorship was 15.1% (95% CI:13.9–16.3) at 24.0 years. In patients <35 years at surgery, survival was significantly better (24.1%) compared to ≥35 years (8.0%) (p = 0.017). In knees with no-to-mild cartilage damage more allografts survived (43.0%) compared to moderate-to-severe damage (6.6%) (p = 0.003). Simultaneous osteotomy significantly deteriorated survival (0% at 24.0 years) (p = 0.010). 61% of patients underwent at least one additional surgery (1–11) for clinical symptoms after MAT. Consecutive radiographs showed significant OA progression at a mean of 3.8 years (p<0.0001). Incremental Kellgren-Lawrence grade was +1,1 grade per 1000 days (2,7yrs). Conclusions MAT did not delay or prevent tibiofemoral OA progression. 19.2% were converted to a knee prosthesis at a mean of 10.3 years. Patients younger than 35 with no-to-mild cartilage damage may benefit from MAT for relief of symptoms (survivorship 51.9% at 20.2 years), but patients and healthcare payers and providers should be aware of the high number of surgical re-interventions.
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Affiliation(s)
- Catherine Van Der Straeten
- Musculoskeletal Sciences and Technology, Department of Surgery and Cancer, Imperial College London, London, United Kingdom
- * E-mail:
| | - Paul Byttebier
- Department Orthopaedics and Traumatology, Ghent University Hospital, Ghent, Belgium
| | - Annelies Eeckhoudt
- Department Orthopaedics and Traumatology, Ghent University Hospital, Ghent, Belgium
| | - Jan Victor
- Department Orthopaedics and Traumatology, Ghent University Hospital, Ghent, Belgium
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