Burnett WD, et al. - In this present study, the physicians examined the relationships between proximal tibial trabecular (epiphyseal and metaphyseal) bone mineral density (BMD) and osteoarthritis (OA)-related pain in patients with severe knee OA. They suggested that low proximal tibial trabecular BMD might have a role in OA-related pain pathogenesis.

Methods

• Quantitative computed tomography (QCT) was applied for knee scan in 42 patients undergoing knee arthroplasty.
• With radiographic Kellgren-Lawrence scoring, OA severity was classified.
• Pain was measured using the pain subsection of the Western Ontario and McMaster Universities Arthritis Index (WOMAC).
• Three-dimensional image processing techniques were used to determine tibial epiphyseal trabecular BMD between the epiphyseal line and 7.5 mm from the subchondral surface and tibial metaphyseal trabecular BMD 10 mm distal from the epiphyseal line.
• Regional analysis included the total epiphyseal and metaphyseal region, and the medial and lateral epiphyseal compartments.
• The association between total WOMAC pain scores and BMD measurements was assessed using hierarchical multiple regression with age, sex, and body mass index (BMI) as covariates.
• Statistical significance was set at p < 0.05.

Results

• Total WOMAC pain was associated with total epiphyseal BMD adjusted for age, sex, and BMI (p = 0.013) and total metaphyseal BMD (p = 0.017).
• Regionally, total WOMAC pain was associated with medial epiphyseal BMD adjusted for age, sex, and BMI (p = 0.006).