Investigating Bone Remodelling in Knee Osteoarthritis Using HR-PQCT Imaging

Osteoarthritis (OA) is the most common type of arthritis and a significant cause of disability worldwide. With an aging population in Canada, the prevalence and burden of OA is expected to increase. Knee OA is the most common form of OA, comprising upwards of 30% of cases. Early-stage OA can be difficult to diagnose, as often times pain and radiographical evidence do not align; however, abnormal subchondral bone remodelling has been considered to have an important role in OA pathogenesis, and some propose that it could offer a target for OA treatment. Clinically, measures of bone remodelling have been performed on iliac crest bone biopsies that are invasive and do not capture local changes. Recently, high resolution peripheral quantitative computed tomography (HR-pQCT) has been utilized in several different ways to analyse bone dynamics, or how the bone changes over time. These measurements are sensitive to several factors such as noise and motion but have yet to be validated in humans. The purpose of this study was to determine whether HR-pQCT can be used to measure longitudinal bone remodelling at the knee in humans with knee OA. Longitudinal bone remodelling results were compared to same-day rescan images to conduct a repeatability analysis. There were no significant differences between longitudinal and rescan results for bone formation (p = 0.47), bone resorption (p = 0.12), or net bone remodelling (p = 0.748). Additionally, the least detectable changes measured were 10.88% for bone formation, 10.53% for bone resorption, and 4.05% for net bone remodelling. These results indicate that with the current imaging procedures, there is too much error in the scans and processing pipeline to measure bone remodelling longitudinally in-vivo in the knee.

Year	Entry
2015	Oftadeh R, Perez-Viloria M, Villa-Camacho JC, Vaziri A, Nazarian A. Biomechanics and mechanobiology of trabecular bone: a review. J Biomech Eng. January 2015;137(1):010802.
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2020	Shiraishi K, Chiba K, Okazaki N, Yokota K, Nakazoe Y, Kidera K, Yonekura A, Tomita M, Osaki M. In vivo analysis of subchondral trabecular bone in patients with osteoarthritis of the knee using second-generation high-resolution peripheral quantitative computed tomography (HR-pQCT). Bone. March 2020;132:115155.
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Year

Entry

2015

Oftadeh R, Perez-Viloria M, Villa-Camacho JC, Vaziri A, Nazarian A. Biomechanics and mechanobiology of trabecular bone: a review. J Biomech Eng. January 2015;137(1):010802.

2014

Kawalilak CE, Johnston JD, Olszynski WP, Kontulainen SA. Characterizing microarchitectural changes at the distal radius and tibia in postmenopausal women using HR-pQCT. Osteoporos Int. August 2014;25(8):2057-2066.

2020

Shiraishi K, Chiba K, Okazaki N, Yokota K, Nakazoe Y, Kidera K, Yonekura A, Tomita M, Osaki M. In vivo analysis of subchondral trabecular bone in patients with osteoarthritis of the knee using second-generation high-resolution peripheral quantitative computed tomography (HR-pQCT). Bone. March 2020;132:115155.

1995

Glüer C-C, Blake G, Lu Y, Blunt BA, Jergas M, Genant HK. Accurate assessment of precision errors: how to measure the reproducibility of bone densitometry techniques. Osteoporos Int. July 1995;5(4):262-270.

2006

Hayami T, Pickarski M, Zhuo Y, Wesolowski GA, Rodan GA, Duong LT. Characterization of articular cartilage and subchondral bone changes in the rat anterior cruciate ligament transection and meniscectomized models of osteoarthritis. Bone. February 2006;38(2):234-243.