Bone turnover and articular cartilage differences localized to subchondral cysts in knees with advanced osteoarthritis
Bone turnover and articular cartilage differences localized to subchondral cysts in knees with advanced osteoarthritis
复制标题
晚期骨关节炎膝关节软骨下囊肿的骨转换和关节软骨差异
DOI：
10.1016/j.joca.2015.07.012
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发表时间：
2015-12-01
影响因子：
7
通讯作者：
Lu, W. W.
中科院分区：
文献类型：
--
作者：
Chen, Y.;Wang, T.;Lu, W. W.
目的：目的：探讨膝关节骨性关节炎（OA）患者软骨下骨囊肿（SBC）区骨结构、骨转换和关节软骨的变化。使用微型计算机断层扫描识别SBC，并将标本分为非囊肿组（n = 25）和骨囊肿组（n = 72）。采用骨体积分数（BV/TV）、骨小梁数（Tb.N）、结构模型指数（SMI）和骨密度（BMD）评价软骨下骨的显微结构。在骨囊肿组中，进一步选择包含至少一个囊肿的囊肿亚区和不包含囊肿的囊肿周围亚区进行显微结构分析。使用国际骨关节炎研究协会（OARSI）评分评估关节软骨损伤。结果：骨囊肿组软骨下骨BV/TV、Tb.N、SMI均高于非囊肿组，骨囊肿组软骨下骨BV/TV、Tb.N、SMI均高于非囊肿组。囊肿亚区BV/TV、Tb.N较囊肿周围亚区增高，BMD、SMI较囊肿周围亚区降低。骨囊肿组OARSI评分明显高于对照组。骨囊肿组TRAP（+）破骨细胞、Osterix（+）骨祖细胞、Osteocalcin（+）成骨细胞数量及SOX 9表达均高于对照组。结论：膝关节OA内骨囊肿具有局灶性骨转换增加、骨结构改变及关节软骨损伤加重的特点。骨转换增加可能导致SBC区域骨结构改变，从而加剧关节软骨退变。(C)2015国际骨关节炎研究学会。由爱思唯尔有限公司出版。保留所有权利。
Objective: To investigate changes in bone structure, turnover, and articular cartilage localized in subchondral bone cyst (SBC) regions associated with knee osteoarthritis (OA).Methods: Tibial plateaus (n = 97) were collected from knee OA patients during total knee arthroplasty (TKA). SBCs were identified using micro-computed tomography, and the specimens were divided into non-cyst (n = 25) and bone cyst (n = 72) groups. Microstructure of subchondral bone was assessed using bone volume fraction (BV/TV), trabecular number (Tb.N), structure model index (SMI) and bone mineral density (BMD). In bone cyst group, the cyst subregion, which contained at least one cyst, and the peri-cyst subregion, which contained no cysts, were further selected for microstructure analysis. Articular cartilage damage was estimated using the Osteoarthritis Research Society International (OARSI) score. The numbers of TRAP(+) osteoclasts, Osterix(+) osteoprogenitors, Osteocalcin(+) osteoblasts and expression of SOX9 were evaluated by immunohistochemistry.Results: Bone cyst group presented higher BV/TV, Tb.N and SMI at subchondral bone than non-cyst group. Furthermore, cyst subregion displayed increased BV/TV and Tb.N but lower BMD and SMI than peri-cyst subregion. Histology revealed a higher OARSI score in bone cyst group. SBC exhibited a weak relationship with BV/TV, etc. The numbers of TRAP(+) osteoclasts, Osterix(+) osteoprogenitors, Osteocalcin(+) osteoblasts and expression of SOX9, were higher in bone cyst group.Conclusion: SBCs within knee OA are characterized by focally increased bone turnover, altered bone structure and more severe articular cartilage damage. The increased bone turnover possibly contributes to altered bone structure localized in SBC areas, and thus aggravates articular cartilage degeneration. (C) 2015 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.