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Knee Alignment Is Quantitatively Related to Periarticular Bone Morphometry and Density, Especially in Patients With Osteoarthritis
Author(s) -
Lo Grace H.,
Merchant Mehveen G.,
Driban Jeffrey B.,
Duryea Jeffrey,
Price Lori Lyn,
Eaton Charles B.,
McAlindon Timothy E.
Publication year - 2018
Publication title -
arthritis and rheumatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.106
H-Index - 314
eISSN - 2326-5205
pISSN - 2326-5191
DOI - 10.1002/art.40325
Subject(s) - osteoarthritis , medicine , bone mineral , magnetic resonance imaging , anatomy , subchondral bone , bone density , trabecular bone , nuclear medicine , orthodontics , osteoporosis , articular cartilage , radiology , pathology , alternative medicine
Objective Static alignment influences knee loading and predicts osteoarthritis ( OA ) progression. Periarticular bone is important in dispersing forces across the knee, and there is substantial evidence for molecular crosstalk between cartilage and subchondral bone. The aim of this study was to evaluate the relationship between periarticular trabecular bone morphology and bone mineral density ( BMD ) and knee alignment in OA. Methods This was a cross‐sectional analysis of participants in the Osteoarthritis Initiative Bone Ancillary Study. Dual x‐ray absorptiometry ( DXA ) was performed to measure tibial periarticular bone mineral density (pa BMD ). Magnetic resonance imaging of knee trabecular bone was performed to calculate the apparent bone volume fraction ( aBVF ), apparent trabecular number ( aTbN ), apparent trabecular spacing ( aTbS p), and apparent trabecular thickness ( aTbT h). Static alignment was assessed by measuring the hip–knee–ankle ( HKA ) angle on long‐limb films. Results The study group comprised 436 participants (mean ± SD age 65.4 ± 9.2 years, 46% female, mean ± SD body mass index 29.6 ± 4.6 kg/m 2 ), 71% of whom had OA . Correlations between the HKA angle and medial:lateral pa BMD , medial pa BMD , aBVF , aTbN , aTbT h, and aTbS p were –0.63, –0.34, –0.29, –0.32, –0.22, and 0.30, respectively. More varus alignment was associated with higher medial:lateral pa BMD , medial pa BMD , aBVF , aTbN , aTbT h, and lower aTbS p. In OA knees, the results were more pronounced. In non‐ OA knees, the most consistent association was with medial:lateral paBMD. Conclusion Static alignment was associated with medial:lateral pa BMD in all knees and with medial pa BMD and trabecular morphometry in OA knees only. Aberrant knee loading may lead to increased relative subchondral bone density, which is partly related to a higher aBVF and a greater number of thicker trabeculae with smaller intertrabecular spacing. Knee DXA may be a useful early biomarker of knee OA.