Ankle flexor torque, size and density are differential determinants of distal tibia trabecular plate-rod morphometry and bone strength:​ the ankle quality study

Wong, Andy K. O.; Fung, Hugo J. W.; Chan, Adrian C. H.; Szabo, Eva; Mathur, Sunita; Giangregorio, Lora; Cheung, Angela M.

Affiliations

¹Joint Department of Medical Imaging, University Health Network, Toronto, ON, Canada

²Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada

³Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada

⁴Department of Exercise Sciences, Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada

⁵Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada

⁶Osteoporosis Program, Schroeder Arthritis Institute, University Health Network, Toronto, ON, Canada

⁷School of Rehabilitation Therapy, Queen's University, Kingston, ON, Canada

⁸Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada

Abstract and keywords

Hypothesis: Greater peak torque and higher myotendinous density at the ankle are associated with a more plate-like architecture at the distal tibia.

Methods: In this cross-sectional study, women and men ≥ 50 years old with no metal implants, reconstructive surgery, muscular dystrophies, or tendinopathies in any leg were recruited by convenience. Isometric ankle dorsi-plantar flexion and inversion-eversion peak torques were measured using dynamometry. HR-pQCT distal tibia scans were completed. Both assessments were completed on the same day on the non-dominant leg. Integral and trabecular vBMD were derived from standard analyses, failure load (FL) was obtained from finite element analysis, plate-specific parameters were computed from individual trabecula segmentation (ITS) analysis, myotendinous density (MyD) and volume fraction (MyV/TV) were computed from soft tissue analysis. pQCT scans of the 66 % mid-leg were performed (500 μm at 15 mm/s) to obtain muscle density (MD) and muscle cross-sectional area (MCSA).

Statistical analysis: General linear models estimated how ankle muscle group torque and muscle size and density differentially related, both separately and together, to whole-bone properties (integral vBMD, FL) and trabecular morphometry (ITS plate parameters). Models were adjusted for age, sex, BMI, use of glucocorticoids, current osteoarthritis, and participation in moderate to vigorous recreational or sport activities.

Results: Among 105 participants (77 % female, mean age: 63 (10) years, BMI: 25.8 (5.4) kg/m², 25 % with OA, 17 % fracture history, 42 % falls history), all torque measures, particularly ankle dorsiflexion and eversion, were correlates of plate-plate/rod junction density and failure load. However, muscle size and density measures were further associated with vBMD. The effect of greater ankle flexor-extensor torque on more connected bone was stronger when MyD was higher (interaction p < 0.001).

Conclusion: Strength of muscles around the ankle are correlates of plate-like trabeculae at the distal tibia, while leaner muscle and myotendinous tissues facilitates better quality bone for stronger ankle muscle torque.

Keywords: Ankle muscle group torque; Muscle size and density; Trabecular connectivity; HR-pQCT

Links

DOI: 10.1016/j.bone.2022.116582

PubMed: 36243400

WoS: 000917330600006

History

Received: 2022-08-11

Revised: 2022-09-23

Accepted: 2022-10-6

Online: 2022-10-12

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