Subchondral bone remodeling is related to clinical improvement after joint distraction in the treatment of ankle osteoarthritis.
Subchondral bone remodeling is related to clinical improvement after joint distraction in the treatment of ankle osteoarthritis.
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DOI：
10.1016/j.joca.2011.02.005
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发表时间：
2011-06
影响因子：
7
通讯作者：
Saltzman, C. L.
中科院分区：
文献类型：
--
作者：
Intema, F.;Thomas, T. P.;Anderson, D. D.;Elkins, J. M.;Browns, T. D.;Amendola, A.;Lafeber, F. P. J. G.;Saltzman, C. L.
In osteoarthritis (OA), subchondral bone changes alter the joint’s mechanical environment and potentially influence progression of cartilage degeneration. Joint distraction as a treatment for OA has been shown to provide pain relief and functional improvement through mechanisms that are not well understood. This study evaluated whether subchondral bone remodeling was associated with clinical improvement in OA patients treated with joint distraction. Twenty-six patients with advanced post-traumatic ankle OA were treated with joint distraction for three months using an Ilizarov frame in a referral center. Primary outcome measure was bone density change analyzed on CT scans. Longitudinal, manually segmented CT datasets for a given patient were brought into a common spatial alignment. Changes in bone density (Hounsfield Units (HU), relative to baseline) were calculated at the weight-bearing region, extending subchondrally to a depth of 8 mm. Clinical outcome was assessed using the ankle OA scale. Baseline scans demonstrated subchondral sclerosis with local cysts. At one and two years of follow-up, an overall decrease in bone density (−23% and −21%, respectively) was observed. Interestingly, density in originally low-density (cystic) areas increased. Joint distraction resulted in a decrease in pain (from 60 to 35, scale of 100) and functional deficit (from 67 to 36). Improvements in clinical outcomes were best correlated with disappearance of low-density (cystic) areas (r=0.69). Treatment of advanced post-traumatic ankle OA with three months of joint distraction resulted in bone density normalization that was associated with clinical improvement.
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影响因子：
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作者：
Hwang, Jennifer;Bae, Won C.;Shieu, Wendy;Lewis, Chad W.;Bugbee, William D.;Sah, Robert L.
通讯作者：
Sah, Robert L.
影响因子：
2.7
作者：
Domsic, RT;Saltzman, CL
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Saltzman, CL
DOI：
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