Knee osteoarthritis patients with severe nocturnal pain have altered proximal tibial subchondral bone mineral density
| Autor: | David R. Wilson, Carl T. Talmo, Christine E. McLennan, Diane Hazel, David J. Hunter, Saija A. Kontulainen, James D. Johnston, Wadena D. Burnett |
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| Rok vydání: | 2014 |
| Předmět: |
musculoskeletal diseases
Male medicine.medical_specialty WOMAC Multivariate analysis medicine.medical_treatment Biomedical Engineering Arthritis Pain Osteoarthritis Rheumatology Bone Density medicine Humans Knee Orthopedics and Sports Medicine Quantitative computed tomography Computed tomography Rank correlation Aged Retrospective Studies Orthodontics Core (anatomy) medicine.diagnostic_test Tibia business.industry Subchondral bone Middle Aged Osteoarthritis Knee medicine.disease Arthroplasty Proximal tibia Physical therapy Female business Tomography X-Ray Computed |
| Zdroj: | Osteoarthritis and cartilage. 23(9) |
| ISSN: | 1522-9653 |
| Popis: | Summary Objective Our objective was to investigate relationships between proximal tibial subchondral bone mineral density (BMD) and nocturnal pain in patients with knee osteoarthritis (OA). Methods The preoperative knee of 42 patients booked for knee arthroplasty was scanned using quantitative computed tomography (QCT). Pain was measured using the Western Ontario and McMaster Universities Arthritis Index (WOMAC) and participants were categorized into three groups: ‘no pain', ‘moderate pain', and ‘severe pain' while lying down at night. We used depth-specific image processing to assess tibial subchondral BMD at normalized depths of 0–2.5 mm, 2.5–5.0 mm and 5–10 mm relative to the subchondral surface. Regional analyses of each medial and lateral plateau included total BMD and maximum BMD within a 10 mm diameter core or ‘focal spot'. The association between WOMAC pain scores and BMD measurements was assessed using Spearman's rank correlation. Regional BMD was compared pairwise between pain and no pain groups using multivariate analysis of covariance using age, sex, and BMI as covariates and Bonferroni adjustment for multiple comparisons. Results Lateral focal BMD at the 2.5–5 mm depth was related to nocturnal pain ( ρ = 0.388, P = 0.011). The lateral focal BMD was 33% higher in participants with ‘severe pain' than participants with ‘no pain' at 2.5–5 mm depth ( P = 0.028) and 32% higher at 5–10 mm depth ( P = 0.049). There were no BMD differences at 0–2.5 mm from the subchondral surface. Conclusion This study suggests that local subchondral bone density may have a role in elucidating OA-related pain pathogenesis. |
| Databáze: | OpenAIRE |
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