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Horizontal fissuring at the osteochondral interface: a novel and unique pathological feature in patients with obesity-related osteoarthritis
OBJECTIVES: Obesity is a well-recognised risk factor for osteoarthritis (OA). Our aim is to characterise body mass index (BMI)-associated pathological changes in the osteochondral unit and determine if obesity is the major causal antecedent of early joint replacement in patients with OA. METHODS: We...
Autores principales: | , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7286031/ https://www.ncbi.nlm.nih.gov/pubmed/32269059 http://dx.doi.org/10.1136/annrheumdis-2020-216942 |
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author | Chen, Lianzhi Yao, Felix Wang, Tao Li, Guangyi Chen, Peilin Bulsara, Max Zheng, Jessica Jun Yi Landao-Bassonga, Euphemie Firth, Marty Vasantharao, Praveen Huang, Yigang Lorimer, Michelle Graves, Stephen Gao, Junjie Carey-Smith, Richard Papadimitriou, John Zhang, Changqing Wood, David Jones, Christopher Zheng, Minghao |
author_facet | Chen, Lianzhi Yao, Felix Wang, Tao Li, Guangyi Chen, Peilin Bulsara, Max Zheng, Jessica Jun Yi Landao-Bassonga, Euphemie Firth, Marty Vasantharao, Praveen Huang, Yigang Lorimer, Michelle Graves, Stephen Gao, Junjie Carey-Smith, Richard Papadimitriou, John Zhang, Changqing Wood, David Jones, Christopher Zheng, Minghao |
author_sort | Chen, Lianzhi |
collection | PubMed |
description | OBJECTIVES: Obesity is a well-recognised risk factor for osteoarthritis (OA). Our aim is to characterise body mass index (BMI)-associated pathological changes in the osteochondral unit and determine if obesity is the major causal antecedent of early joint replacement in patients with OA. METHODS: We analysed the correlation between BMI and the age at which patients undergo total knee replacement (TKR) in 41 023 patients from the Australian Orthopaedic Association National Joint Replacement Registry. We then investigated the effect of BMI on pathological changes of the tibia plateau of knee joint in a representative subset of the registry. RESULTS: 57.58% of patients in Australia who had TKR were obese. Patients with overweight, obese class I & II or obese class III received a TKR 1.89, 4.48 and 8.08 years earlier than patients with normal weight, respectively. Microscopic examination revealed that horizontal fissuring at the osteochondral interface was the major pathological feature of obesity-related OA. The frequency of horizontal fissure was strongly associated with increased BMI in the predominant compartment. An increase in one unit of BMI (1 kg/m(2)) increased the odds of horizontal fissures by 14.7%. 84.4% of the horizontal fissures were attributable to obesity. Reduced cartilage degradation and alteration of subchondral bone microstructure were also associated with increased BMI. CONCLUSIONS: The key pathological feature in OA patients with obesity is horizontal fissuring at the osteochondral unit interface. Obesity is strongly associated with a younger age of first TKR, which may be a result of horizontal fissures. |
format | Online Article Text |
id | pubmed-7286031 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-72860312020-06-15 Horizontal fissuring at the osteochondral interface: a novel and unique pathological feature in patients with obesity-related osteoarthritis Chen, Lianzhi Yao, Felix Wang, Tao Li, Guangyi Chen, Peilin Bulsara, Max Zheng, Jessica Jun Yi Landao-Bassonga, Euphemie Firth, Marty Vasantharao, Praveen Huang, Yigang Lorimer, Michelle Graves, Stephen Gao, Junjie Carey-Smith, Richard Papadimitriou, John Zhang, Changqing Wood, David Jones, Christopher Zheng, Minghao Ann Rheum Dis Osteoarthritis OBJECTIVES: Obesity is a well-recognised risk factor for osteoarthritis (OA). Our aim is to characterise body mass index (BMI)-associated pathological changes in the osteochondral unit and determine if obesity is the major causal antecedent of early joint replacement in patients with OA. METHODS: We analysed the correlation between BMI and the age at which patients undergo total knee replacement (TKR) in 41 023 patients from the Australian Orthopaedic Association National Joint Replacement Registry. We then investigated the effect of BMI on pathological changes of the tibia plateau of knee joint in a representative subset of the registry. RESULTS: 57.58% of patients in Australia who had TKR were obese. Patients with overweight, obese class I & II or obese class III received a TKR 1.89, 4.48 and 8.08 years earlier than patients with normal weight, respectively. Microscopic examination revealed that horizontal fissuring at the osteochondral interface was the major pathological feature of obesity-related OA. The frequency of horizontal fissure was strongly associated with increased BMI in the predominant compartment. An increase in one unit of BMI (1 kg/m(2)) increased the odds of horizontal fissures by 14.7%. 84.4% of the horizontal fissures were attributable to obesity. Reduced cartilage degradation and alteration of subchondral bone microstructure were also associated with increased BMI. CONCLUSIONS: The key pathological feature in OA patients with obesity is horizontal fissuring at the osteochondral unit interface. Obesity is strongly associated with a younger age of first TKR, which may be a result of horizontal fissures. BMJ Publishing Group 2020-06 2020-04-08 /pmc/articles/PMC7286031/ /pubmed/32269059 http://dx.doi.org/10.1136/annrheumdis-2020-216942 Text en © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. |
spellingShingle | Osteoarthritis Chen, Lianzhi Yao, Felix Wang, Tao Li, Guangyi Chen, Peilin Bulsara, Max Zheng, Jessica Jun Yi Landao-Bassonga, Euphemie Firth, Marty Vasantharao, Praveen Huang, Yigang Lorimer, Michelle Graves, Stephen Gao, Junjie Carey-Smith, Richard Papadimitriou, John Zhang, Changqing Wood, David Jones, Christopher Zheng, Minghao Horizontal fissuring at the osteochondral interface: a novel and unique pathological feature in patients with obesity-related osteoarthritis |
title | Horizontal fissuring at the osteochondral interface: a novel and unique pathological feature in patients with obesity-related osteoarthritis |
title_full | Horizontal fissuring at the osteochondral interface: a novel and unique pathological feature in patients with obesity-related osteoarthritis |
title_fullStr | Horizontal fissuring at the osteochondral interface: a novel and unique pathological feature in patients with obesity-related osteoarthritis |
title_full_unstemmed | Horizontal fissuring at the osteochondral interface: a novel and unique pathological feature in patients with obesity-related osteoarthritis |
title_short | Horizontal fissuring at the osteochondral interface: a novel and unique pathological feature in patients with obesity-related osteoarthritis |
title_sort | horizontal fissuring at the osteochondral interface: a novel and unique pathological feature in patients with obesity-related osteoarthritis |
topic | Osteoarthritis |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7286031/ https://www.ncbi.nlm.nih.gov/pubmed/32269059 http://dx.doi.org/10.1136/annrheumdis-2020-216942 |
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