Binks, D. A., Gravallese, E. M., Bergin, D., Hodgson, R. J., Tan, A. L., Matzelle, M. M., McGonagle, D. and Radjenovic, A. (2015) Role of vascular channels as a novel mechanism for subchondral bone damage at cruciate ligament entheses in osteoarthritis and inflammatory arthritis. Annals of the Rheumatic Diseases, 74(1), pp. 196-203. (doi: 10.1136/annrheumdis-2013-203972)
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Abstract
Objectives: The purpose of this work was to test whether normal peri-entheseal vascular anatomy at anterior and posterior cruciate ligaments (ACL and PCL) was associated with distribution of peri-entheseal bone erosion/bone marrow lesions (BMLs) in inflammatory arthritis (IA) and osteoarthritis (OA).<p></p> Methods: Normal microanatomy was defined histologically in mice and by 3 T MRI and histology in 21 cadaveric knees. MRI of 89 patients from the Osteoarthritis Initiative and 27 patients with IA was evaluated for BMLs at ACL and PCL entheses. Antigen-induced arthritis (AIA) in mice was evaluated to ascertain whether putative peri-entheseal vascular regions influenced osteitis and bone erosion.<p></p> Results: Vascular channels penetrating cortical bone were identified in knees of non-arthritic mice adjacent to the cruciate ligaments. On MRI of normal cadavers, vascular channels adjacent to the ACL (64% of cases) and PCL (71%) entheses were observed. Histology of 10 macroscopically normal cadaveric specimens confirmed the location of vascular channels and associated subclinical changes including subchondral bone damage (80% of cases) and micro-cyst formation (50%). In the AIA model, vascular channels clearly provided a site for inflammatory tissue entry and osteoclast activation. MRI showed BMLs in the same topographic locations in both patients with early OA (41% ACL, 59% PCL) and IA (44%, 33%).<p></p> Conclusion: The findings show that normal ACL and PCL entheses have immediately adjacent vascular channels which are common sites of subtle bone marrow pathology in non-arthritic joints. These channels appear to be key determinants in bone damage in inflammatory and degenerative arthritis.
Item Type: | Articles |
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Status: | Published |
Refereed: | Yes |
Glasgow Author(s) Enlighten ID: | Radjenovic, Dr Aleksandra |
Authors: | Binks, D. A., Gravallese, E. M., Bergin, D., Hodgson, R. J., Tan, A. L., Matzelle, M. M., McGonagle, D., and Radjenovic, A. |
College/School: | College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health |
Journal Name: | Annals of the Rheumatic Diseases |
Publisher: | B M J Group |
ISSN: | 0003-4967 |
ISSN (Online): | 1468-2060 |
Copyright Holders: | Copyright © 2013 The Authors |
First Published: | First published Annals of the Rheumatic Diseases 74(1):196-203 |
Publisher Policy: | Reproduced under a Creative Commons License |
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