Subchondral bone micro-architectural alterations in osteoarthritis: a synchrotron micro-computed tomography study

Abstract

Objectives: We evaluated the three-dimensional (3D) micro-architecture of subchondral trabecular (Tb) bone in osteoarthritis (OA). Due to high signal-to-noise ratio and high resolution, micro-computed tomography (micro-CT) by synchrotron radiation is considered as the gold standard for bone micro-architecture imaging.

Design: Subchondral bone were extracted from femoral heads in OA cases in areas without cartilage (OAc-; n=6) and in adjacent areas with cartilage (OAc+; n=6) and compared to eight subchondral bone cores from osteoporosis cases (OP). The voxel size of images was 10.13 microm. We measured the bone volume fraction (BV/TV) and morphological parameters: Tb thickness (TbTh), Tb spacing (TbSp), Tb number (TbN), and bone surface/bone volume (BS/BV). The degree of anisotropy (DA), the connectivity by the Euler number and the degree of mineralization (DM) were equally assessed.

Results: BV/TV and morphological parameters showed significant differences between OAc- and OP samples (P<0.01 except TbTh: P<0.05) and between OAc- and OAc+ (0.05<P<0.01) but no difference between OAc+ and OP except TbN (P<0.01). The connectivity was higher in OAc- comparatively to OAc+ and OP. The DA were significantly different between OA and OP cases (P<0.01) but not between OAc- and OAc+ specimens. The DMs (mean+/-SD) were 0.817+/-0.142 g/cm(3), 0.873+/-0.161 g/cm(3), 0.906+/-0.156 g/cm(3) for OAc-, OAc+, OP (P<0.01), respectively.

Conclusion: Subchondral bone changes were mainly observed in advanced OA, when cartilage has been deleted and preserved in adjacent area. These data suggest that subchondral bone changes would be rather secondary to the cartilage deterioration than a primitive mechanism of OA. Nevertheless, longitudinal data could bring more accurate conclusions.