Articular Cartilage Degradation and Aberrant Subchondral Bone Remodeling in Patients with Osteoarthritis and Osteoporosis
Articular Cartilage Degradation and Aberrant Subchondral Bone Remodeling in Patients with Osteoarthritis and Osteoporosis
复制标题
骨关节炎和骨质疏松症患者的关节软骨退化和异常软骨下骨重塑。
DOI：
10.1002/jbmr.3909
复制
发表时间：
2020-03-01
影响因子：
6.2
通讯作者：
Yu, Zhifeng
中科院分区：
文献类型：
--
作者：
Chu, Linyang;Liu, Xuqiang;Yu, Zhifeng
骨关节炎（OA）和骨质疏松症（OP）是两种与关节结构相关的骨骼疾病。偶尔，OA和OP发生在同一患者中。然而，骨质疏松性OA（OP-OA）患者OP变化对OA进展的影响尚未报道，特别是软骨下骨和关节软骨之间的潜在相关性。因此，我们研究了OP-OA患者髋关节中软骨下骨的微观结构、生物力学特性和重塑的改变以及它们与软骨损伤的关系。39例股骨头标本来自接受全髋关节置换术的患者（OA组，n=19; OP-OA组，n=20），并使用来自尸体供体的健康标本（对照组，n=10）。通过显微CT和有限元分析，评价软骨下骨的显微结构和生物力学性能。组织学、组织形态学测量和免疫组织化学用于评估软骨下骨重建和软骨损伤。采用直线回归分析方法，探讨软骨下骨与关节软骨的关系。与OA组相比，OP-OA组的软骨下骨中，异常的骨重建导致微观结构劣化和生物力学性能恶化，可能影响载荷应力从软骨到软骨下骨的传递，从而导致OP-OA患者OA进展加速。结果表明，软骨下骨的变化可能会影响OA的发展和改善软骨下骨与骨代谢药物可能有助于减轻OA的进展时，OP和OA共存于同一患者。(c)2019年美国骨与矿物质研究学会。
Osteoarthritis (OA) and osteoporosis (OP) are two skeletal disorders associated with joint structures. Occasionally, OA and OP occur in the same patient. However, the effect of OP changes on OA progression in patients with osteoporotic OA (OP-OA) has not been reported, especially the potential association between subchondral bone and articular cartilage. Thus we investigated the alterations in the microstructure, biomechanical properties, and remodeling of subchondral bone as well as their association with cartilage damage in the hip joint of patients with OP-OA. Thirty-nine femoral head specimens were obtained from patients who underwent total hip arthroplasty (OA group, n=19; OP-OA group, n=20), and healthy specimens from cadaver donors were used (control group, n=10). The microstructure and biomechanical properties of subchondral bone were evaluated by micro-computed tomography and micro-finite-element analysis. Histology, histomorphometric measurements, and immunohistochemistry were used to assess subchondral bone remodeling and cartilage damage. Linear regression analysis was performed to elucidate the relationship between subchondral bone and articular cartilage. In the subchondral bone of the OP-OA group, compared with that of the OA group, aberrant bone remodeling leads to an inferior microstructure and worsening biomechanical properties, potentially affecting transmission of loading stress from the cartilage to the subchondral bone, and then resulting in accelerated OA progression in patients with OP-OA. The results indicate that changes in subchondral bone could affect OA development and the improvement in subchondral bone with bone-metabolism agents may help mitigate OA progression when OP and OA coexist in the same patients. (c) 2019 American Society for Bone and Mineral Research.