A systematic review of the relationship between subchondral bone features, pain and structural pathology in peripheral joint osteoarthritis.
A systematic review of the relationship between subchondral bone features, pain and structural pathology in peripheral joint osteoarthritis.
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DOI：
10.1186/s13075-015-0735-x
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发表时间：
2015-08-25
影响因子：
4.9
通讯作者：
Conaghan PG
中科院分区：
文献类型：
--
作者：
Barr AJ;Campbell TM;Hopkinson D;Kingsbury SR;Bowes MA;Conaghan PG
骨是骨关节炎（OA）过程中不可分割的一部分。我们进行了系统的文献综述，以了解外周关节OA中软骨下骨的非常规影像学、疼痛、结构病理和关节置换术之间的关系。我们对Medline、EMBASE和Cochrane图书馆数据库进行了检索，寻找报道非传统影像学评估的软骨下骨病变与膝关节、髋关节、手部、踝关节和足部OA的关节置换术、疼痛或结构进展之间关系的原创文章。每个关联通过基于研究设计、协变量调整的充分性和质量评分的每个分析数据的综合来定性表征。共筛选2456篇摘要，纳入139篇论文（70篇横断面分析，71篇纵向分析；116篇膝关节分析，15篇髋部分析，6篇手部分析，2篇踝关节及相关部位分析，113篇MRI分析，8篇DXA分析，4篇CT分析，8篇MRI分析和8篇2D形状分析）。骨瘤、骨赘和骨形状与结构进展或关节置换术独立相关。骨密度和骨形状分别与疼痛的纵向变化和频繁的膝关节疼痛事件独立相关。软骨下骨特征与髋关节和手部外周性骨关节炎的结构进展、疼痛和关节置换术有独立的关联，尤其是在膝关节。对于除膝关节以外的外周OA部位，骨病理与这些重要的OA结果的关联和独立关联较少，这可能反映的研究较少；例如，对脚和脚踝的研究很少。软骨下OA骨似乎是一个相关的治疗靶点。本文的在线版本（doi:10.1186/s13075-015-0735-x）包含补充材料，仅供授权用户使用。
Bone is an integral part of the osteoarthritis (OA) process. We conducted a systematic literature review in order to understand the relationship between non-conventional radiographic imaging of subchondral bone, pain, structural pathology and joint replacement in peripheral joint OA. A search of the Medline, EMBASE and Cochrane library databases was performed for original articles reporting association between non-conventional radiographic imaging-assessed subchondral bone pathologies and joint replacement, pain or structural progression in knee, hip, hand, ankle and foot OA. Each association was qualitatively characterised by a synthesis of the data from each analysis based upon study design, adequacy of covariate adjustment and quality scoring. In total 2456 abstracts were screened and 139 papers were included (70 cross-sectional, 71 longitudinal analyses; 116 knee, 15 hip, six hand, two ankle and involved 113 MRI, eight DXA, four CT, eight scintigraphic and eight 2D shape analyses). BMLs, osteophytes and bone shape were independently associated with structural progression or joint replacement. BMLs and bone shape were independently associated with longitudinal change in pain and incident frequent knee pain respectively. Subchondral bone features have independent associations with structural progression, pain and joint replacement in peripheral OA in the hip and hand but especially in the knee. For peripheral OA sites other than the knee, there are fewer associations and independent associations of bone pathologies with these important OA outcomes which may reflect fewer studies; for example the foot and ankle were poorly studied. Subchondral OA bone appears to be a relevant therapeutic target. PROSPERO registration number: CRD 42013005009 The online version of this article (doi:10.1186/s13075-015-0735-x) contains supplementary material, which is available to authorized users.