Thickness of the bone-cartilage unit in relation to osteoarthritis severity in the human hip joint

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Thickness of the bone-cartilage unit in relation to osteoarthritis severity in the human hip joint. / Hartlev, Louise Brøndt; Klose-Jensen, Rasmus; Thomsen, Jesper Skovhus; Nyengaard, Jens Randel; Boel, Lene Warner Thorup; Laursen, Mogens Berg; Laurberg, Trine Bay; Nielsen, Andreas Wiggers; Steengaard-Pedersen, Kristian; Hauge, Ellen-Margrethe.

I: RMD Open, Bind 4, Nr. 2, e000747, 21.09.2018.

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@article{64397199a3ec4941bda7d7c1e1eba868,
title = "Thickness of the bone-cartilage unit in relation to osteoarthritis severity in the human hip joint",
abstract = "Objective: Bone formation is a hallmark of osteoarthritis (OA). It has been speculated that bone formation may occur because of ossification at the bone-cartilage unit, that is, bone formation directly involving the calcified cartilage (CC). This study aimed to investigate the thickness of the CC and subchondral bone (SCB) in relation to the severity of the overlying articular cartilage (AC) degeneration.Design: We investigated femoral heads from 20 patients with OA and 15 healthy subjects with design-based stereology using systematic uniform random sampling of the entire joint surface. This was combined with the Osteoarthritis Research Society International (OARSI) OA cartilage histopathology assessment system, thus obtaining focal OARSI grades paired with thickness measurements of AC, CC and the SCB.Results: The patients with OA had thicker CC (mean 159; 95{\%} CI 144 to 177 µm) compared with the healthy subjects (mean 132; 95{\%} CI 113 to 1550 µm; p=0.036), and this difference was even higher in areas without loss of AC thickness (OARSI grade ≤3); 187 (95{\%} CI 164 to 214) µm vs 132 (95{\%} CI 113 to 155) µm (p=0.001). In the patients with OA, a thicker SCB was observed in areas with loss of AC thickness (OARSI grade ≥4), but not in areas without loss of AC thickness (OARSI grade ≤3).Conclusion: The study showed that thicker CC is present in early stages of OA, suggesting that bone formation by endochondral ossification is an early phenomenon of OA. Thickening of the SCB was present, but only in areas with denuded bone. Suggesting that also appositional bone growth occurs and that it may be a consequence of changed biomechanics.",
author = "Hartlev, {Louise Br{\o}ndt} and Rasmus Klose-Jensen and Thomsen, {Jesper Skovhus} and Nyengaard, {Jens Randel} and Boel, {Lene Warner Thorup} and Laursen, {Mogens Berg} and Laurberg, {Trine Bay} and Nielsen, {Andreas Wiggers} and Kristian Steengaard-Pedersen and Ellen-Margrethe Hauge",
year = "2018",
month = "9",
day = "21",
doi = "10.1136/rmdopen-2018-000747",
language = "English",
volume = "4",
journal = "RMD Open",
issn = "2056-5933",
publisher = "BMJ Group",
number = "2",

}

RIS

TY - JOUR

T1 - Thickness of the bone-cartilage unit in relation to osteoarthritis severity in the human hip joint

AU - Hartlev, Louise Brøndt

AU - Klose-Jensen, Rasmus

AU - Thomsen, Jesper Skovhus

AU - Nyengaard, Jens Randel

AU - Boel, Lene Warner Thorup

AU - Laursen, Mogens Berg

AU - Laurberg, Trine Bay

AU - Nielsen, Andreas Wiggers

AU - Steengaard-Pedersen, Kristian

AU - Hauge, Ellen-Margrethe

PY - 2018/9/21

Y1 - 2018/9/21

N2 - Objective: Bone formation is a hallmark of osteoarthritis (OA). It has been speculated that bone formation may occur because of ossification at the bone-cartilage unit, that is, bone formation directly involving the calcified cartilage (CC). This study aimed to investigate the thickness of the CC and subchondral bone (SCB) in relation to the severity of the overlying articular cartilage (AC) degeneration.Design: We investigated femoral heads from 20 patients with OA and 15 healthy subjects with design-based stereology using systematic uniform random sampling of the entire joint surface. This was combined with the Osteoarthritis Research Society International (OARSI) OA cartilage histopathology assessment system, thus obtaining focal OARSI grades paired with thickness measurements of AC, CC and the SCB.Results: The patients with OA had thicker CC (mean 159; 95% CI 144 to 177 µm) compared with the healthy subjects (mean 132; 95% CI 113 to 1550 µm; p=0.036), and this difference was even higher in areas without loss of AC thickness (OARSI grade ≤3); 187 (95% CI 164 to 214) µm vs 132 (95% CI 113 to 155) µm (p=0.001). In the patients with OA, a thicker SCB was observed in areas with loss of AC thickness (OARSI grade ≥4), but not in areas without loss of AC thickness (OARSI grade ≤3).Conclusion: The study showed that thicker CC is present in early stages of OA, suggesting that bone formation by endochondral ossification is an early phenomenon of OA. Thickening of the SCB was present, but only in areas with denuded bone. Suggesting that also appositional bone growth occurs and that it may be a consequence of changed biomechanics.

AB - Objective: Bone formation is a hallmark of osteoarthritis (OA). It has been speculated that bone formation may occur because of ossification at the bone-cartilage unit, that is, bone formation directly involving the calcified cartilage (CC). This study aimed to investigate the thickness of the CC and subchondral bone (SCB) in relation to the severity of the overlying articular cartilage (AC) degeneration.Design: We investigated femoral heads from 20 patients with OA and 15 healthy subjects with design-based stereology using systematic uniform random sampling of the entire joint surface. This was combined with the Osteoarthritis Research Society International (OARSI) OA cartilage histopathology assessment system, thus obtaining focal OARSI grades paired with thickness measurements of AC, CC and the SCB.Results: The patients with OA had thicker CC (mean 159; 95% CI 144 to 177 µm) compared with the healthy subjects (mean 132; 95% CI 113 to 1550 µm; p=0.036), and this difference was even higher in areas without loss of AC thickness (OARSI grade ≤3); 187 (95% CI 164 to 214) µm vs 132 (95% CI 113 to 155) µm (p=0.001). In the patients with OA, a thicker SCB was observed in areas with loss of AC thickness (OARSI grade ≥4), but not in areas without loss of AC thickness (OARSI grade ≤3).Conclusion: The study showed that thicker CC is present in early stages of OA, suggesting that bone formation by endochondral ossification is an early phenomenon of OA. Thickening of the SCB was present, but only in areas with denuded bone. Suggesting that also appositional bone growth occurs and that it may be a consequence of changed biomechanics.

U2 - 10.1136/rmdopen-2018-000747

DO - 10.1136/rmdopen-2018-000747

M3 - Journal article

C2 - 30271622

VL - 4

JO - RMD Open

JF - RMD Open

SN - 2056-5933

IS - 2

M1 - e000747

ER -