整形外科における臨床研究

Osteoarthritis of the Anterior Cruciate Ligament and the Medial Tibial Plateau: Public health considerations from a Cadaveric Model

Jessica Immonen

Some at-risk populations for Osteoarthritis (OA) have been identified yet the literature makes little suggestion regarding precise age of disease onset or preventative strategies to reduce risk for disease onset in various groups. In 2008, the American College of Rheumatology estimated that 37.4% of 60+ years old Americans are affected by knee OA. This analysis suggests that this is largely underestimated. Morphometric analyses of the articular cartilage of the tibial plateau were performed on cadaver specimens using Image ProÒ software on three age populations: <70 years old, 70-79 years old and ³80 years old. The articular cartilage of the medial tibial plateau in ³80 years old specimens showed a 1.7-fold increase in surface area degeneration (mm2) compared to 70-79 years old specimens (P<0.05). This degradation was compared to donors’ reported histories. Data showed that by the 7th decade of life, when patients are in their 60s, articular cartilage degeneration on the tibial plateau had commenced in 100% of specimen. All donors that reported homemaker as an occupation displayed above average medial tibial plateau degeneration (32.33±24.85%) for their age group while simultaneously reporting pathologies in their clinical history that encourage a sedentary lifestyle. This assessment identifies an occupational class that should be aware of their propensity to develop disease while considering the concept that an appropriate BMI does not guarantee joint health. This assessment also identifies a more realistic time frame than previous public health advisory committees have produced regarding age of disease onset and initiation of preventative measures.