The Subchondral Bone Plate

Inhaltsangabe1 Introduction (Review of Literature).- 1.1 Preliminary Remarks.- 1.2 General Mechanisms for the Regulation of the Morphology of Bone Tissue.- 1.3 Morphology of the Subchondral Bone.- 1.3.1 Definition of the Term "Subchondral Bone".- 1.3.2 Structure of Normal Subchondral Bone.- 1.3.2.1 Architecture.- 1.3.2.2 Vascularity of the Subchondral Bone Plate.- 1.3.2.3 Thickness of the Subchondral Bone Plate.- 1.3.2.4 Density Distribution in the Subchondral Plate.- 1.3.3 Structure of Pathologically Altered Subchondral Bone.- 1.3.3.1 In Osteoarthritis (OA).- 1.3.3.2 In Chondromalacia Patellae.- 1.3.4 Mechanical Properties of the Subchondral Bone Plate in Normal and Pathological Conditions.- 1.3.4.1 Strength of Subchondral Bone.- 1.3.4.2 Stiffness of the Subchondral Bone Plate.- 1.3.4.3 Energy Absorption Capacity of the Subchondral Bone Plate.- 1.3.4.4 Hardness of the Subchondral Bone Plate.- 1.3.5 Correlation Between Structural Parameters and Mechanical Properties.- 1.4 Function of the Subchondral Bone Plate.- 1.5 Possible Pathomechanisms Leading to Osteoarthritic Changes.- 1.5.1 Is Osteoarthritis a "Final Common Pathway"?.- 1.6 Factors Regulating the Remodeling of the Subchondral Bone.- 1.7 The Aims of this Investigation.- 2 Materials.- 2.1 Material for the Validation of CT-OAM.- 2.2 Materials Used for CT-OAM.- 2.2.1 Spine Samples.- 2.2.2 Shoulder Joint Samples.- 2.2.3 Elbow Joint Samples.- 2.2.4 Radiocarpal Joint Samples.- 2.2.5 Hip Joint Samples.- 2.2.6 Femorotibial Joint Samples.- 2.2.7 Animal Studies of the Femorotibial Joint.- 2.2.8 Femoropatellar Joint Samples.- 2.2.9 Ankle Joint Samples.- 3 Methods.- 3.1 X-ray Densitometry.- 3.2 CT OAM Used to Demonstrate the Patterns of Subchondral Mineralization in the Living Subject.- 3.2.1 CT OAM With a Radiotherapy Planning Computer.- 3.2.2 CT OAM With an X-Ray Computer Tomograph.- 3.2.3 CT OAM Processed by Means of the Software ANALYZE.- 3.3 The Production of Secondary Sections.- 3.4 Dual-energy QCT with basis material decomposition.- 3.5 Methods of Achieving Standardized Evaluation and Quantification of the Mineralization Patterns.- 3.5.1 Localization and Displacement of the Maxima.- 3.5.2 Degree of Mineralization.- 3.5.3 Extent of Changes in Depth.- 4 Validation of CT OAM.- 4.1 Comparison with Conventional Procedures.- 4.1.1 The Physical Background to the Assessment of the Mineral Content of Bone Tissue by Means of the X-Ray Densitometry of Thin Sections and Using CT or DEQCT.- 4.1.2 The Basis of X-Ray Densitometry.- 4.1.3 The Basis of CT OAM.- 4.1.4 Conventional X-Ray Densitometry as Applied to Physical Sections Compared with CT OAM.- 4.1.4.1 First Model (Two Component Model).- 4.1.4.2 Second Model (Four Component Model).- 4.2 Dependence of the Absorption Value on the Calcium Concentration.- 4.2.1 Fundamentals of Dual Energy Quantitative Computed Tomography (DEQCT) with Basis Material Decomposition.- 4.2.1.1 Selective Measurement and Imaging of Substances.- 4.2.1.2 Calibration of Values Against a Standard Phantom Bone.- 4.2.2 Comparison of the Hounsfield and Calcium Values.- 4.3 The Use of CT OAM in Connection With Sections Cut at Other Angles.- 5 Mineralization Patterns in Healthy Subjects.- 5.1 Vertebral Column (Lumbar Region).- 5.2 Shoulder Joint.- 5.2.1 Control Group.- 5.2.2 Mineralization Patterns of Athletes.- 5.2.3 Mineralization Patterns in Cases of Unreduced Traumatic Dislocation of the Shoulder Joint.- 5.3 Elbow Joint.- 5.4 Radiocarpal Joint.- 5.5 Hip Joint.- 5.6 Femorotibial Joint.- 5.7 Femoropatellar Joint.- 5.8 Ankle Joint.- 6 Pathological Mineralization Patterns.- 6.1 Vertebral Column.- 6.1.1 Low-Grade Scoliosis.- 6.2 Shoulder Joint.- 6.2.1 Comparison Between Individuals with Healthy and Diseased Shoulders.- 6.3 Radiocarpal Joint.- 6.3.1 Healed Defective Repositioning of a Distal Fracture of the Radius.- 6.3.2 Kienböck's Disease (Avascular Necrosis of the Lunate).- 6.4 Hip Joint.- 6.4.1 Dysplasia of the Hip.- 6.5 Femorotibial Joint.- 6.5.1 Patterns in Patients with Malalign

Inhaltsangabe1 Introduction (Review of Literature).- 1.1 Preliminary Remarks.- 1.2 General Mechanisms for the Regulation of the Morphology of Bone Tissue.- 1.3 Morphology of the Subchondral Bone.- 1.3.1 Definition of the Term "Subchondral Bone".- 1.3.2 Structure of Normal Subchondral Bone.- 1.3.2.1 Architecture.- 1.3.2.2 Vascularity of the Subchondral Bone Plate.- 1.3.2.3 Thickness of the Subchondral Bone Plate.- 1.3.2.4 Density Distribution in the Subchondral Plate.- 1.3.3 Structure of Pathologically Altered Subchondral Bone.- 1.3.3.1 In Osteoarthritis (OA).- 1.3.3.2 In Chondromalacia Patellae.- 1.3.4 Mechanical Properties of the Subchondral Bone Plate in Normal and Pathological Conditions.- 1.3.4.1 Strength of Subchondral Bone.- 1.3.4.2 Stiffness of the Subchondral Bone Plate.- 1.3.4.3 Energy Absorption Capacity of the Subchondral Bone Plate.- 1.3.4.4 Hardness of the Subchondral Bone Plate.- 1.3.5 Correlation Between Structural Parameters and Mechanical Properties.- 1.4 Function of the Subchondral Bone Plate.- 1.5 Possible Pathomechanisms Leading to Osteoarthritic Changes.- 1.5.1 Is Osteoarthritis a "Final Common Pathway"?.- 1.6 Factors Regulating the Remodeling of the Subchondral Bone.- 1.7 The Aims of this Investigation.- 2 Materials.- 2.1 Material for the Validation of CT-OAM.- 2.2 Materials Used for CT-OAM.- 2.2.1 Spine Samples.- 2.2.2 Shoulder Joint Samples.- 2.2.3 Elbow Joint Samples.- 2.2.4 Radiocarpal Joint Samples.- 2.2.5 Hip Joint Samples.- 2.2.6 Femorotibial Joint Samples.- 2.2.7 Animal Studies of the Femorotibial Joint.- 2.2.8 Femoropatellar Joint Samples.- 2.2.9 Ankle Joint Samples.- 3 Methods.- 3.1 X-ray Densitometry.- 3.2 CT OAM Used to Demonstrate the Patterns of Subchondral Mineralization in the Living Subject.- 3.2.1 CT OAM With a Radiotherapy Planning Computer.- 3.2.2 CT OAM With an X-Ray Computer Tomograph.- 3.2.3 CT OAM Processed by Means of the Software ANALYZE.- 3.3 The Production of Secondary Sections.- 3.4 Dual-energy QCT with basis material decomposition.- 3.5 Methods of Achieving Standardized Evaluation and Quantification of the Mineralization Patterns.- 3.5.1 Localization and Displacement of the Maxima.- 3.5.2 Degree of Mineralization.- 3.5.3 Extent of Changes in Depth.- 4 Validation of CT OAM.- 4.1 Comparison with Conventional Procedures.- 4.1.1 The Physical Background to the Assessment of the Mineral Content of Bone Tissue by Means of the X-Ray Densitometry of Thin Sections and Using CT or DEQCT.- 4.1.2 The Basis of X-Ray Densitometry.- 4.1.3 The Basis of CT OAM.- 4.1.4 Conventional X-Ray Densitometry as Applied to Physical Sections Compared with CT OAM.- 4.1.4.1 First Model (Two Component Model).- 4.1.4.2 Second Model (Four Component Model).- 4.2 Dependence of the Absorption Value on the Calcium Concentration.- 4.2.1 Fundamentals of Dual Energy Quantitative Computed Tomography (DEQCT) with Basis Material Decomposition.- 4.2.1.1 Selective Measurement and Imaging of Substances.- 4.2.1.2 Calibration of Values Against a Standard Phantom Bone.- 4.2.2 Comparison of the Hounsfield and Calcium Values.- 4.3 The Use of CT OAM in Connection With Sections Cut at Other Angles.- 5 Mineralization Patterns in Healthy Subjects.- 5.1 Vertebral Column (Lumbar Region).- 5.2 Shoulder Joint.- 5.2.1 Control Group.- 5.2.2 Mineralization Patterns of Athletes.- 5.2.3 Mineralization Patterns in Cases of Unreduced Traumatic Dislocation of the Shoulder Joint.- 5.3 Elbow Joint.- 5.4 Radiocarpal Joint.- 5.5 Hip Joint.- 5.6 Femorotibial Joint.- 5.7 Femoropatellar Joint.- 5.8 Ankle Joint.- 6 Pathological Mineralization Patterns.- 6.1 Vertebral Column.- 6.1.1 Low-Grade Scoliosis.- 6.2 Shoulder Joint.- 6.2.1 Comparison Between Individuals with Healthy and Diseased Shoulders.- 6.3 Radiocarpal Joint.- 6.3.1 Healed Defective Repositioning of a Distal Fracture of the Radius.- 6.3.2 Kienböck's Disease (Avascular Necrosis of the Lunate).- 6.4 Hip Joint.- 6.4.1 Dysplasia of the Hip.- 6.5 Femorotibial Joint.- 6.5.1 Patterns in Patients with Malalign