Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/121739
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Type: Journal article
Title: Bone marrow lesions in knee osteoarthritis: regional differences in tibial subchondral bone microstructure and their association with cartilage degeneration
Author: Muratovic, D.
Findlay, D.
Cicuttini, F.
Wluka, A.
Lee, Y.
Edwards, S.
Kuliwaba, J.
Citation: Osteoarthritis and Cartilage, 2019; 27(11):1653-1662
Publisher: Elsevier
Issue Date: 2019
ISSN: 1063-4584
1522-9653
Statement of
Responsibility: 
D. Muratovic, D.M. Findlay, F.M. Cicuttini, A.E. Wluka, Y.R. Leey, S. Edwards, J.S. Kuliwaba
Abstract: OBJECTIVE:The aim of this study was to investigate how bone microstructure within bone marrow lesions (BMLs) relates to the bone and cartilage across the whole human tibial plateau. DESIGN:Thirty-two tibial plateaus from patients with osteoarthritis (OA) at total knee arthroplasty and eleven age-matched non-OA controls, were scanned ex vivo by MRI to identify BMLs and by micro CT to quantitate the subchondral (plate and trabecular) bone microstructure. For cartilage evaluation, specimens were processed histologically. RESULTS:BMLs were detected in 75% of the OA samples (OA-BML), located predominantly in the anterior-medial (AM) region. In contrast to non-OA control and OA-no BML, in OA-BML differences in microstructure were significantly more evident between subregions. In OA-BML, the AM region contained the most prominent structural alterations. Between-group comparisons showed that the AM region of the OA-BML group had significantly higher histological degeneration (OARSI grade) (P < .0001, P < .05), thicker subchondral plate (P < .05, P < .05), trabeculae that are more anisotropic (P < .0001, P < .05), well connected (P < .05, P = n.s), and more plate-like (P < 0.05, P < 0.05), compared to controls and OA-no BML at this site. Compared to controls, OA-no BML had significantly higher OARSI grade (P < .0001), and lower trabecular number (P < .05). CONCLUSION:In established knee OA, both the extent of cartilage damage and microstructural degeneration of the subchondral bone were dependent on the presence of a BML. In OA-no BML, bone microstructural alterations are consistent with a bone attrition phase of the disease. Thus, the use of BMLs as MRI image-based biomarkers appear to inform on the degenerative state within the osteochondral unit.
Keywords: Bone marrow lesion; Cartilage volume; Knee osteoarthritis; Micro CT; Subchondral bone microarchitecture
Rights: Crown Copyright © 2019 Published by Elsevier Ltd on behalf of Osteoarthritis Research SocietyInternational. All rights reserved.
RMID: 0030120698
DOI: 10.1016/j.joca.2019.07.004
Grant ID: http://purl.org/au-research/grants/nhmrc/1042482
http://purl.org/au-research/grants/nhmrc/1063574
Appears in Collections:Medicine publications

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