大骨节病与骨性关节炎骨显微结构的比较研究

Comparative study of bone micro-structure between Kashin Beck disease and osteoarthritis

目的本研究旨在比较大骨节病(Kashin Beck disease,KBD)和骨性关节炎(osteoarthritis,OA)患者胫骨平台松质骨显微结构差异。方法选取2017—2019年在我院行膝关节置换手术的39例大骨节病患者和38例骨性关节炎患者。从患者胫骨截除的骨质上采集直径10 mm、高6 mm的圆柱状松质骨样本,10%多聚甲醛保存。通过Micro-CT扫描分析,分别比较KBD组和OA组骨小梁厚度(trabecular thickness,Tb.Th),骨小梁连接密度(connection density,CD),骨密度(bone mineral density,BMD)、骨体积分数(bone volume fraction,BVF),骨小梁结构模型指数(structure model index,SMI)。结果KBD组Tb.Th高于OA组[(0.12±0.02)mm vs(0.09±0.02)mm,P<0.05],KBD组CD小于OA组[(1.90±1.23)/mm^3 vs(5.01±2.62)/mm^3,P<0.05]。两组间BMD(P=0.404)、BVF(P=0.481)和SMI(P=0.105)差异无统计学意义。结论KBD患者松质骨Tb.Th大于OA患者,而KBD患者松质骨CD小于OA患者。KBD患者和OA患者骨显微结构的差异及其引起的力学性能的不同,对于膝关节假体的设计具有指导意义。

Objective To compare the micro-structure of trabecular bone between Kashin Beck disease(KBD)and osteoarthritis(OA).Methods A total of 39 patients with Kashin Beck disease and 38 patients with osteoarthritis who underwent knee arthroplasty in our hospital from 2017 to 2019 were selected.The 6 mm by 10 mm cylindrical trabecular bone samples were collected from the proximal of tibia and preserved in formaldehyde.The trabecular thickness(TB.Th),trabecular connection density(CD),bone mineral density(BMD),bone volume fraction(BVF)and trabecular structure model index(SMI)of the samples were compared by Micro-CT analysis.Results Tb.Th in KBD group was higher than that in OA group[(0.12±0.02)mm vs(0.09±0.02)mm,P<0.05],and CD in KBD group was lower than that in OA group[(1.90±1.23)/mm^3 vs(5.01±2.62)/mm^3,P<0.05].There was no significant difference in BMD(P=0.404),BVF(P=0.481)and SMI(P=0.105)between the two groups.Conclusion There are significant differences in trabecular thickness and connection density between KBD and OA patients,which provide a theoretical basis for further study of trabecular biomechanics and design of special tibial prosthesis for KBD.