COMPROMISED TRABECULAR BONE OF THE KNEE IS A DOSE-DEPENDENT CORRELATE OF MORE SEVERE OSTEOPHYTES AND ADVANCED KLG
Notice bibliographique
Résumé
INTRODUCTION Previous studies have shown that bone turnover is elevated, and fracture risk is higher among knee osteoarthritis (KOA) patients, especially in later stages of disease. While there have been mixed findings with respect to areal bone mineral density (BMD)’s association with KOA severity, it remains unclear how volumetric bone morphometry at the knee is related to the development of radiographic disease features such as osteophytosis and attrition. OBJECTIVE It was hypothesized that having definite osteophytosis and attrition are each associated with compromised subchondral bone, including lower volumetric(v) BMD, apparent v.Tissue Mineral Density (vTMD) and a wider Tb.Sp. METHODS In this cross-sectional study, women 50-85 years old were recruited by convenience sample if they experienced knee pain ≥3 days a week, each lasting >3 hours, and if self-reported body mass index (BMI) was <30 kg/m 2 . On the knee with worse symptoms, they completed a peripheral quantitative CT (pQCT) knee scan, one slice (2.3±0.5mm, 200µm in-plane) prescribed per tibiofemoral compartment; and an anteroposterior knee X-ray for KLG, including breakdown semi-quantitative evaluation of osteophytosis, attrition, JSN, and sclerosis. pQCT knee images were analyzed using a previously reported iterative threshold-seeking algorithm (Tam et al. Skeletal Muscle 27(14) 2024) to separate trabecular bone from marrow. Apparent structural parameters were derived from bone volume, bone surface, and total volume according to equations by Parfitt’s model of parallel plates. General linear models examined how KLG and osteophyte score, and each of established (score > 2) KOA (KL), osteophytosis, and attrition were related to knee vBMD, vTMD, app: Tb.Sp, Tb.Th, Tb.N, and BV/TV. Models adjusted for age, BMI, use of pain medications, antiresorptives, glucocorticoids or intra-articular steroid injections. RESULTS Among 105 women (mean(SD) age: 62.6(9.0)yrs, BMI: 24.2(3.5)kg/m 2 , median KLG: 1(1,2), 41(39.1%) with established KOA), a higher KLG or established KOA were each associated with lower vBMD and vTMD (with effects larger for vTMD), and a larger app.Tb.Sp; though, only in advanced stage (KLG3/4) individuals (Table1). Attrition was only associated with larger Tb.Sp in the lateral femur. Having more advanced osteophytosis was dose-dependently linked to lower vBMD and larger app.Tb.Sp (Figure 1). These effects were only present at the femur and not the tibia, with magnitudes appearing larger in themedial compartment among moderate grade (score 2) knees, but dose-dependently only in the lateral compartment. CONCLUSION Among peri- to post-menopausal women without obesity, compromised bone characterized by lower apparent bone density and less intact trabecular structure, may be key correlates of having more advanced radiographic KOA largely driven by osteophytosis. Structural differences may not be adequately apparent in the subchondral tibia using pQCT, perhaps due to damage that may simulate higher bone volume fraction. More sensitive techniques or metrics are needed to distinguish damaged bone from intact but diminished structures.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».