{"title":"The Hounsfield Unit Values of Talar Subchondral Bone Predict Articular Cartilage Degeneration in Patients With Ankle Osteoarthritis.","authors":"Saori Ishibashi, Tomoyuki Nakasa, Yasunari Ikuta, Shingo Kawabata, Dan Moriwaki, Satoru Sakurai, Nobuo Adachi","doi":"10.1177/10711007241268111","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Therapeutic strategies for ankle osteoarthritis (OA) are determined based on OA staging, alignment, and articular cartilage conditions. However, it is difficult to evaluate the degeneration of the remaining cartilage using imaging modalities. Subchondral bone plays a crucial role in maintaining cartilage homeostasis. Measurement of local Hounsfield unit (HU) values allows for the quantitative assessment of small changes in the subchondral bone. This study aimed to evaluate a relationship between the HU values of the subchondral bone and the histologic findings of articular cartilage in ankle OA.</p><p><strong>Methods: </strong>The talar articular surface was harvested from 14 ankles during arthroplasty. The talus was divided into anterior, middle, and posterior parts, and histologic specimens were prepared. Safranin O staining was performed and histologic findings were evaluated using the modified Mankin score. The regions of interest (ROIs) were set in the medial, central, and lateral regions of the specimens and computed tomography (CT) images, and the relationship between the HU values and histologic findings was analyzed.</p><p><strong>Results: </strong>As OA progressed, cartilage defects increased. In conjunction with cartilage degeneration, the subchondral bone plate thickened, and the HU values increased. The HU value significantly and positively correlated with the modified Mankin score (<i>r</i> = 0.756), subchondral bone thickness (<i>r</i> = 0.674, <i>P</i> < .01), and trabecular bone area (<i>r</i> = 0.637). The cutoff HU values were 594 (sensitivity, 0.813; specificity, 0.944) for 3 points and 727 (sensitivity, 0.929; specificity, 0.782) for 11 points on the modified Mankin score.</p><p><strong>Conclusion: </strong>Significant correlations between HU values and cartilage degeneration in ankle OA were noted. Measuring HU values on CT images can be useful for evaluating the joint surface condition, including histologic findings of the remaining cartilage.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"1292-1301"},"PeriodicalIF":0.0000,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Foot & ankle international","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/10711007241268111","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/8/26 0:00:00","PubModel":"Epub","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Therapeutic strategies for ankle osteoarthritis (OA) are determined based on OA staging, alignment, and articular cartilage conditions. However, it is difficult to evaluate the degeneration of the remaining cartilage using imaging modalities. Subchondral bone plays a crucial role in maintaining cartilage homeostasis. Measurement of local Hounsfield unit (HU) values allows for the quantitative assessment of small changes in the subchondral bone. This study aimed to evaluate a relationship between the HU values of the subchondral bone and the histologic findings of articular cartilage in ankle OA.
Methods: The talar articular surface was harvested from 14 ankles during arthroplasty. The talus was divided into anterior, middle, and posterior parts, and histologic specimens were prepared. Safranin O staining was performed and histologic findings were evaluated using the modified Mankin score. The regions of interest (ROIs) were set in the medial, central, and lateral regions of the specimens and computed tomography (CT) images, and the relationship between the HU values and histologic findings was analyzed.
Results: As OA progressed, cartilage defects increased. In conjunction with cartilage degeneration, the subchondral bone plate thickened, and the HU values increased. The HU value significantly and positively correlated with the modified Mankin score (r = 0.756), subchondral bone thickness (r = 0.674, P < .01), and trabecular bone area (r = 0.637). The cutoff HU values were 594 (sensitivity, 0.813; specificity, 0.944) for 3 points and 727 (sensitivity, 0.929; specificity, 0.782) for 11 points on the modified Mankin score.
Conclusion: Significant correlations between HU values and cartilage degeneration in ankle OA were noted. Measuring HU values on CT images can be useful for evaluating the joint surface condition, including histologic findings of the remaining cartilage.
背景：踝关节骨关节炎（OA）的治疗策略是根据 OA 分期、对位和关节软骨情况来确定的。然而，使用成像模式很难评估剩余软骨的退化情况。软骨下骨在维持软骨平衡方面起着至关重要的作用。测量局部 Hounsfield 单位（HU）值可对软骨下骨的微小变化进行定量评估。本研究旨在评估软骨下骨的 HU 值与踝关节 OA 关节软骨组织学检查结果之间的关系：方法：在进行关节置换术时，从 14 个踝关节中采集了距骨关节面。将距骨分为前、中、后三部分，并制备组织学标本。进行 Safranin O 染色，并使用改良的 Mankin 评分对组织学结果进行评估。在标本和计算机断层扫描（CT）图像的内侧、中央和外侧区域设置感兴趣区（ROI），并分析 HU 值与组织学结果之间的关系：结果：随着 OA 的发展，软骨缺损增加。结果：随着 OA 的发展，软骨缺损增加，软骨退化的同时，软骨下骨板增厚，HU 值增加。HU 值与改良 Mankin 评分（r = 0.756）、软骨下骨厚度（r = 0.674，P r = 0.637）呈明显正相关。改良 Mankin 评分 3 分的 HU 临界值为 594（灵敏度为 0.813；特异性为 0.944），11 分的 HU 临界值为 727（灵敏度为 0.929；特异性为 0.782）：结论：HU值与踝关节OA软骨退化之间存在显著相关性。在 CT 图像上测量 HU 值有助于评估关节表面状况，包括剩余软骨的组织学发现。
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