University of Twente Student Theses


Change in 3d periarticular bone density after Knee Joint Distraction or High Tibial Osteotomy in the treatment of osteoarthritis

Coorens, N.A. and Ensink, C.J. and Graaf, J.W. VAN DER and Schippers, B. (2016) Change in 3d periarticular bone density after Knee Joint Distraction or High Tibial Osteotomy in the treatment of osteoarthritis.

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Abstract:Background: Osteoarthritis (OA) is a degenerative joint disease, associated with both cartilage and periarticular bone change. High Tibial Osteotomy (HTO) is a generally considered method for prolonging the time before a total knee replacement is necessary and to reduce the pain in patients suffering from OA. A relatively new technique is Knee Joint Distraction (KJD). Although there is evidence for an improvement of cartilage after KJD, changes in periarticular bone have not yet been investigated. Objective: The main goal of this research is to determine the difference in quality of periarticular bone of the tibia before and two years after treatment with KJD or HTO using 3D Computed Tomogrophy (CT). Methods: Coronal CT images were obtained from two previous conducted studies, a total of 23 patients (mean age 51 ± 7 years; 15 males, 10 KJD) were included. Changes in bone density are related to changes in intensity, measured in Hounsfield Units (HU). In the assessment of the periarticular bone quality, a distinction was made between subchondral and trabecular bone, by calculating intensities in five different layers to a depth of 5 mm beneath the joint surface of the tibia. Bone quality was expressed in mean absolute deviation (MAD) and mean intensity. Results: Mean intensities seem to be decreased at two year follow up compared to baseline, but these differences were statistically insignificant in both HTO and KJD. Interestingly, in the case of KJD, the MAD of the intensities in all layers of the lateral compartment and some layers of the medial and other compartments, were significantly decreased. Conclusions: The results suggest that periarticular bone density neutralizes. This was statistically indistinguishable for HTO, but MAD decreased significantly for KJD. This indicates that joint distraction has a positive effect on the quality of periarticular bone.
Item Type:Essay (Bachelor)
Faculty:TNW: Science and Technology
Subject:44 medicine
Programme:Technical Medicine BSc (50033)
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