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ARS Home » Northeast Area » Boston, Massachusetts » Jean Mayer Human Nutrition Research Center On Aging » Research » Publications at this Location » Publication #211520

Title: Strong Association Between Tibial Plateau Bone Mineral Density and Cartilage Damage

Author
item LO, GRACE - TUFTS NEMC
item DUMOULIN-RICHEZ, CHANTAL - TUFTS NEMC
item NUITE, MELYNN - TUFTS NEMC
item WHEELER, LAURA - TUFTS NEMC
item BADIANI, PRUTHA - TUFTS NEMC
item JOAS, JOHANE - TUFTS NEMC
item MCADAMS, ERICA - TUFTS NEMC
item Dawson-Hughes, Bess
item CARON, BRENDA - TUFTS HNRCA
item MCALINDON, TIMOTHY - TUFTS NEMC

Submitted to: American College of Rheumatology
Publication Type: Abstract Only
Publication Acceptance Date: 7/1/2007
Publication Date: 11/6/2007
Citation: Lo, G.H., Dumoulin-Richez, C., Nuite, M., Wheeler, L.M., Badiani, P., Joas, J., Mcadams, E.L., Dawson-Hughes, B., Caron, B., Mcalindon, T.E. 2007. Strong Association Between Tibial Plateau Bone Mineral Density and Cartilage Damage. In: American College of Rheumatology Scientific Meeting, 11/6/07-11/11/07, Boston, MA. 56(9 supplement): S125.

Interpretive Summary:

Technical Abstract: Tibial bone mineral density (BMD) is associated with radiographic features of osteoarthritis (OA), but no study has looked at its relationship with a direct measure of cartilage damage. We hypothesize that a relative increase in medial and lateral tibial BMD will be associated with cartilage damage in the respective tibiofemoral compartment in people with knee OA. This was a cross-sectional study of the first 72 participants enrolled in a trial of vitamin D for symptomatic knee OA. Exclusion criteria were the presence of a total joint replacement of the knee of interest or any contraindication to MRI. All participants had knee DXA scans and 1.5 Tesla MRIs including sagittal DESS WE and coronal IW fat suppressed images taken of their study knees. Each MRI was scored by one reader, masked to subject data, for cartilage abnormalities using the Boston Leeds Osteoarthritis Knee Score (BLOKS) scoring system for area of full cartilage thickness loss (0 – 3) in the medial and lateral weight-bearing femur, and the medial and lateral tibia. The weighted kappa (intra-rater reliability) was 0.72 – 1.0. Moderate-severe full cartilage thickness loss in the medial and lateral tibio-femoral (TF) compartments were defined as a maximal BLOKS full cartilage thickness score > 2 in the medial and lateral weight-bearing femur or tibia respectively. Knee DXA scans were used to calculate the medial:lateral tibial plateau BMD (M:L BMD). We performed a logistic regression with case-based tertiles of M:L BMD as predictors and moderate-severe full cartilage thickness loss in the medial TF compartment as the outcome. We repeated the analysis evaluating two case-based groups of M:L BMD as predictors and full cartilage thickness loss in the lateral TF compartment as the outcome. Participants (N=72) had a mean age of 63.8 (+8.6) and BMI of 30.6 (+5.6) and 63% were female. With increasing M:L BMD, the risk of medial TF cartilage damage increased. With decreasing M:L BMD, the risk of lateral TF cartilage damage increased. Therefore, results show that In individuals with symptomatic knee OA, increased periarticular tibial BMD is strongly associated with ipsi-compartmental TF articular cartilage damage. This re-emphasizes the close relationship between cartilage and bone locally in knee OA. The longitudinal study of this relationship is warranted to clarify the temporal relationship between these findings in OA. DXA has potential as an inexpensive, low risk, screening tool that may be able to identify those at high risk for articular cartilage damage.