title: Trabecular orientation in the human femur and tibia and the relationship with lower-limb alignment for patients with osteoarthritis of the knee.
abstract: Wolff׳s Law suggests that the orientation of trabeculae in human bone changes in response to altered loading patterns. The aim of this study was to investigate trabecular orientation in both the femur and tibia and to compare this with the mechanical axis of the leg. The study involved analysis of radiographs from patients with osteoarthritis of the knee (n=91). For each patient, the trabecular orientation in both the distal femur and proximal tibia was measured from a standard anteroposterior radiograph of the knee and the mechanical axis of the leg was calculated from a long leg view taken while weight bearing. There was a significant correlation between the mechanical axis and the trabecular orientation in each of the regions considered in the femur (r=-0.41, -0.30, 0.52, and 0.23) and tibia (r=-0.27 and 0.31). Multiple regression analysis, with mechanical axis as the dependent variable, produced an R(2) of 0.62. Greater trabecular anisotropy (i.e. greater alignment) was observed in the medial femur and tibia compared to the lateral side (p<0.01). The results give an insight into the trabecular changes that may take place during development of osteoarthritis and following surgery. In particular, we propose that the orientation of the trabeculae in both the distal femur and proximal tibia will reflect the angle of mechanical loading through the knee.
authors.affiliation: The Bluespot Knee Clinic, 32 Orchard Road, Lytham, Lancashire, United Kingdom; Manchester Metropolitan University, Crewe Green Road, Crewe CW1 5DU, United Kingdom.
authors.forename: Shameem A
authors.initials: SA
authors.lastname: Sampath
authors.affiliation: Manchester Metropolitan University, Crewe Green Road, Crewe CW1 5DU, United Kingdom. Electronic address: s.lewis@mmu.ac.uk.
authors.forename: Sandra
authors.initials: S
authors.lastname: Lewis
authors.affiliation: Orthopaedic Department, Ospedale di Suzzara, Via Cantore General 14, 46029, Suzzara (MN), Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Fosco
authors.affiliation: Maggiore Hospital, Largo Nigrisoli 2, Bologna, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Tigani
mesh_terms: D000328:Adult; D001696:Biomechanical Phenomena; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000473:pathology; D007866:Leg / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000000981:diagnostic imaging / Q000473:pathology*; D011859:Radiography; D012044:Regression Analysis; D013977:Tibia / Q000000981:diagnostic imaging / Q000473:pathology*; D016474:Weight-Bearing
keywords: Alignment; Knee; Mechanical axis; Trabeculae