, Volume 470, Issue 6, pp 1682-1689
Date: 03 Dec 2011

A Correlation Exists Between Subchondral Bone Mineral Density of the Distal Radius and Systemic Bone Mineral Density

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Abstract

Background

Intraarticular distal radius fractures are common and risk articular congruity owing to disruption of the subchondral bone. Studies regarding microstructure and mechanical properties of the distal radius, however, focus only on the cortical and trabecular bones in the metaphysis and not on the subchondral bone.

Questions/purposes

This study was conducted to (1) quantify the regional bone mineral density of the subchondral plate in the distal radius; (2) analyze the topographic distribution pattern of the subchondral bone mineral density; and (3) evaluate the correlation between the subchondral bone mineral density and the potentially related clinical factors of age, height, weight, BMI, systemic bone mineral densities, socio-occupational classification, and hand osteoarthritis grading.

Methods

Eighty postmenopausal women with a mean age of 68 years (range, 52–88 years) were enrolled in this study. Digital images of the distal radii of the subjects were scanned by conventional CT and processed to provide the regional bone mineral density of the subchondral plate using a CT osteoabsorptiometry technique. The estimated subchondral bone mineral density was analyzed to evaluate the topographic pattern and its correlation with various clinical factors, including age, height, weight, BMI, degree of hand osteoarthritis, socio-occupational class, and systemic bone mineral density measured in the lumbar spine and hip.

Results

During topographic analysis of a densitometric map, a bicentric distribution of the subchondral bone mineral density was found. Among the clinical factors, only the systemic bone mineral density measured by dual-energy x-ray absorptiometry in the femur neck and lumbar spine had a significant correlation with the subchondral bone mineral density of the distal radius.

Conclusion

Systemic bone mineral density correlates substantially with the subchondral bone mineral density of the distal radius as a constitutional factor, whereas other local factors arising from the gravitational load or joint reaction force are not associated with the subchondral bone mineral density of the distal radius.

Level of Evidence

Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.

One of the authors (SHR) has received funding from the Seoul National University Hospital Research Fund (04-2010-0620).
All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request.
Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.
This work was performed at the Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul, Korea.