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Three-Dimensional Analysis of the Trapezium Subchondral Bone and its Association with Trapeziometacarpal Joint Osteoarthritis

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Abstract

Subchondral bone properties are associated with the pathogenesis of osteoarthritis (OA), but this relationship has not been confirmed in the trapeziometacarpal joint (TMCJ). We aimed to evaluate the thickness (SBT) and density (SBD) of three-dimensional (3D) trapezium subchondral bone models derived from computed tomography (CT) images, and their relationships with early-stage TMCJ OA. We reviewed patients with a distal radius fracture who underwent conventional CT scans and such osteoporosis evaluations as bone mineral density (BMD) and bone turnover markers (BTMs). From 3D trapezium subchondral bone models, we measured SBT and SBD according to the OA stage and performed multivariate analyses to evaluate their associations with age, sex, body mass index, BMD, and BTMs. As results, a total of 156 patients (78 men and 78 age-matched women; mean age, 67 ± 10 years) were analyzed. There were 30 (19%) with grade 0, 71 (45%) with grade 1, 13 (8%) with grade 2, and 42 (27%) with grade 3 TMCJ OA. SBT was significantly lower in patients with grade 1 OA than those with grade 0 or grade 3 OA, but SBD generally increased according to the OA severity. Low SBT was associated with low BMD, and low SBD with low BMD, high osteocalcin levels, and severe OA grades. In conclusion, patients with early-stage radiographic TMCJ OA have a lower SBT at the trapezium, which may support the potential role of subchondral bone in OA pathogenesis. This study also shows that subchondral bone properties are associated with BMD and osteocalcin levels.

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Funding

This work was supported by the SNUBH research fund granted by the Seoul National University Bundang Hospital (Grant Number 14-2021-0031), the SNUH research fund granted by the Seoul National University Hospital (Grant Number 0420220570), and the National Research Foundation of Korea (NRF) grant funded by the Korea government (Ministry of Science and ICT) (Grant Number 2020R1A2C1005778).

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Seoul National University Hospital, Seoul, South Korea

    Ji Sup Hwang

  2. Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Gumi-Ro 173, 82 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, 13620, South Korea

    Han Sang Lee & Hyun Sik Gong

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  1. Ji Sup Hwang
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  2. Han Sang Lee
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Contributions

Author HSG designed the study. He is guarantor. Author JSH acquired the data, analyzed and interpreted the data, and prepared the first draft of the paper. He is responsible for statistical analysis of the data. Author HSL contributed to the experimental work. All authors revised the paper critically for intellectual content and approved the final version. All authors agreed to be accountable for the work and to ensure that any questions relating to the accuracy and integrity of the paper are investigated and properly resolved.

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Correspondence to Hyun Sik Gong.

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Ji Sup Hwang, Han Sang Lee, Hyun Sik Gong these authors declare that they have no competing interest.

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Hwang, J.S., Lee, H.S. & Gong, H.S. Three-Dimensional Analysis of the Trapezium Subchondral Bone and its Association with Trapeziometacarpal Joint Osteoarthritis. Calcif Tissue Int 112, 320–327 (2023). https://doi.org/10.1007/s00223-022-01040-5

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