QCT analysis of the effect of knee varus on bone mineral density of medial and lateral femoral tibial compartments in knee osteoarthritis

doi:10.11958/20241245

Abstract

Abstract:

Objective To investigate the differences in subchondral bone mineral density (BMD) between the femoral and tibial sides in patients of knee osteoarthritis (KOA) with normal lines of force and varus. Methods The data of 450 knee joints with a definite diagnosis of KOA were included in this study including weight-bearing full-length X-ray films and quantitative computed tomography (QCT) scans of both lower limbs. Among them, 131 were in the normal force line group and 319 were in the knee varus group. The hip-knee-ankle (HKA) angle and BMD of the femoral medial condyle, femoral lateral condyle, tibial medial plateau and tibial lateral plateau were measured. BMD ratio of tibial medial plateau to tibial lateral plateau and the BMD ratio of femoral medial condyle to femoral lateral condyle were calculated. BMD in medial and lateral compartments of the femur and tibia were compared between the two groups, followed by subgroup analyses based on gender and age. Spearman correlation was used to analyze the correlation between the BMD ratio of tibial medial plateau to tibial lateral plateau, the BMD ratio of femoral medial condyle to femoral lateral condyle and the degree of varus in the knee varus group. Results The BMD of the medial femoral condyles and medial tibial platforms were higher in the knee varus group than those in the normal force line group. The BMD of femoral lateral condyle and lateral tibial platform was lower in the knee varus group than that in the normal force line group. The BMD ratio of the medial to lateral tibial plateaus was greater than one in both groups, and the ratio of the knee varus group was greater. The BMD ratio of femoral medial to lateral condyle in the knee varus group was significantly higher than that in the normal force line group. For women, these findings were more pronounced and were independent of age. Correlation analysis showed that the BMD ratio of medial tibial plateau to lateral tibial plateau was negatively correlated with HKA angle (r_s=-0.436, P < 0.01), and the BMD ratio of the medial femoral condyle to lateral femoral condyle was also negatively correlated with HKA angle (r_s=-0.394, P < 0.01). Conclusion The BMD of medial femoral and tibial compartment is increased and the BMD of lateral compartment is decreased in the genu varus group compared with the normal force line group.

Key words: osteoarthritis, knee varus, bone mineral density, quantitative computed tomography

CLC Number:

R445.4

Figures/Tables 7

References 19

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组别	n	股骨内髁/ （mg/cm³）	股骨外髁/ （mg/cm³）	胫骨内侧平台/ （mg/cm³）	胫骨外侧平台/ （mg/cm³）	胫骨内侧平台/ 胫骨外侧平台	股骨内髁/ 股骨外髁
力线正常组	131	162.0（130.6，195.4）	166.1（136.4，199.9）	125.1（102.0，143.7）	117.7（92.8，137.6）	1.07（1.01，1.15）	0.96（0.93，1.00）
膝内翻组	319	198.1（162.6，245.4）	149.9（122.2，186.9）	163.4（134.0，200.9）	97.9（68.6，123.2）	1.65（1.35，2.19）	1.26（1.14，1.47）
Z		7.085^＊＊	2.885^＊＊	8.718^＊＊	4.337^＊＊	14.425^＊＊	13.808^＊＊

组别	n	股骨内髁/ （mg/cm³）	股骨外髁/ （mg/cm³）	胫骨内侧平台/ （mg/cm³）	胫骨外侧平台/ （mg/cm³）	胫骨内侧平台/ 胫骨外侧平台	股骨内髁/ 股骨外髁
力线正常组	131	162.0（130.6，195.4）	166.1（136.4，199.9）	125.1（102.0，143.7）	117.7（92.8，137.6）	1.07（1.01，1.15）	0.96（0.93，1.00）
膝内翻组	319	198.1（162.6，245.4）	149.9（122.2，186.9）	163.4（134.0，200.9）	97.9（68.6，123.2）	1.65（1.35，2.19）	1.26（1.14，1.47）
Z		7.085^＊＊	2.885^＊＊	8.718^＊＊	4.337^＊＊	14.425^＊＊	13.808^＊＊

组别	n	股骨内髁/ （mg/cm³）	股骨外髁/ （mg/cm³）	胫骨内侧平台/ （mg/cm³）	胫骨外侧平台/ （mg/cm³）	胫骨内侧平台/ 胫骨外侧平台	股骨内髁/ 股骨外髁
力线正常组	52	169.8（154.2，204.4）	177.7（158.7，209.8）	134.6（119.9，155.2）	126.6（113.8，142.9）	1.04（1.00，1.10）	0.96（0.92，0.99）
膝内翻组	106	232.5（189.6，257.1）	187.3（148.4，205.1）	182.8（151.5，206.0）	119.9（102.4，141.6）	1.42（1.25，1.78）	1.23（1.12，1.37）
Z		5.732^＊＊	0.599	6.923^＊＊	1.108	9.303^＊＊	8.596^＊＊

组别	n	股骨内髁/ （mg/cm³）	股骨外髁/ （mg/cm³）	胫骨内侧平台/ （mg/cm³）	胫骨外侧平台/ （mg/cm³）	胫骨内侧平台/ 胫骨外侧平台	股骨内髁/ 股骨外髁
力线正常组	52	169.8（154.2，204.4）	177.7（158.7，209.8）	134.6（119.9，155.2）	126.6（113.8，142.9）	1.04（1.00，1.10）	0.96（0.92，0.99）
膝内翻组	106	232.5（189.6，257.1）	187.3（148.4，205.1）	182.8（151.5，206.0）	119.9（102.4，141.6）	1.42（1.25，1.78）	1.23（1.12，1.37）
Z		5.732^＊＊	0.599	6.923^＊＊	1.108	9.303^＊＊	8.596^＊＊

组别	n	股骨内髁/ （mg/cm³）	股骨外髁/ （mg/cm³）	胫骨内侧平台/ （mg/cm³）	胫骨外侧平台/ （mg/cm³）	胫骨内侧平台/ 胫骨外侧平台	股骨内髁/ 股骨外髁
力线正常组	79	156.8（120.9，182.5）	153.1（125.7，181.1）	117.9（99.1，140.4）	105.0（87.5，130.6）	1.08（1.03，1.20）	0.96（0.93，1.01）
膝内翻组	213	183.0（155.3，225.2）	139.6（110.4，166.9）	156.8（120.6，191.8）	82.7（61.2，107.1）	1.75（1.44，2.40）	1.28（1.15，1.53）
Z		5.429^＊＊	2.710^＊＊	6.480^＊＊	4.553^＊＊	11.151^＊＊	10.750^＊＊