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Title: Do subchondral bone chemical changes predict ankle osteoarthritis?
Author: Chan, Oliver
ISNI:       0000 0004 7970 6670
Awarding Body: UCL (University College London)
Current Institution: University College London (University of London)
Date of Award: 2019
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Introduction: Subchondral bone changes have been identified in hip and knee osteoarthritis (OA) and may serve as predictors of disease onset. Ankle OA in contrast is less common and strongly associated with trauma. The aims of the study were to determine whether subchondral bone changes are also associated with ankle OA. Methods: Subchondral bone specimens were obtained from the distal tibiae of patients undergoing definitive surgery for ankle osteoarthritis. Samples were collected from patients with symmetrically and asymmetrically loaded (varus hindfoot deformity) wear patterns. Comparison was made with matched non-OA controls. Specimens were analysed using Raman spectroscopy and Sodium dodecyl sulphate polyacrylamide gel electrophoresis. Chemical markers of subchondral bone (phosphate: amide I, carbonate: amide I, phosphate:carbonate ratios, phosphate and amide I deconvolutional peak analysis) were calculated from the Raman spectra and principal component analysis was employed to detect inherent differences between the two groups. Sample mineral content and α-1 to α-2 type I collagen ratios were deduced from biochemical analysis. Results: Significant differences within osteoarthritic subchondral bone were observed in the biochemical markers as deduced from Raman spectroscopy (phosphate:amide I , carbonate:amide I, Amide I (1690:1660) ratios (p < 0.05)). Biochemical Analysis revealed that osteoarthritic specimens were hypomineralised and had significantly greater α-1 to α-2 type I collagen ratios. Such changes were also noted to be present in subchondral bone collected from the relatively spared lateral joint surface from patients with a varus wear pattern. Discussion: The results imply that subchondral bone is biochemically altered in patients with ankle osteoarthritis. This raises the possibility that certain patients may be biochemically predisposed to developing ankle osteoarthritis. Although trauma is strongly linked to the development of ankle osteoarthritis, it may be that trauma and/or subsequent joint instability may be an initiator for the disease process in subjects who are "biochemically predisposed".
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available