Differences in trabecular bone texture between knees with and without radiographic osteoarthritis detected by fractal methods

Objective :To develop an accurate method for quantifying differences in the trabecular structure in the tibial bone between subjects with and without knee osteoarthritis (OA). Methods: Standard knee radiographs were taken from 26 subjects (seven women) with meniscectomy and radiographic OA Kellgren & Lawrence grade 2 or worse in the medial compartment. Each case knee was individually matched by sex, age, body mass index and medial or lateral compartment with a control knee. A newly developed augmented Hurst orientation transform (HOT) method was used to calculate texture parameters for regions selected in X-ray images of non-OA and OA tibial bones. This method produces a mean value of fractal dimensions (FDMEAN), FDs in the vertical (FDV) and horizontal (FDH) directions and along a direction of the roughest part of the tibial bone (FDSta), fractal signatures and a texture aspect ratio (Str). The ratio determines a degree of the bone texture anisotropy. Reproducibility was calculated using an intraclass correlation coefficient (ICC). Comparisons between cases and controls were made with paired t tests. The performance of the HOT method was evaluated against a benchmark fractal signature analysis (FSA) method.Results: Compared with controls, trabecular bone in OA knees showed significantly lower FDMEAN, FDV, FDH and FDSta and higher Str at trabecular image sizes 0.2–1.1 mm (P <0.05, HOT). The reproducibility of all parameters was very good (ICC > 0.8). In the medial compartment, fractal signatures calculated for OA horizontal and vertical trabeculae were significantly lower at sizes 0.3–0.55 mm (P <0.05, HOT) and 0.3–0.65 mm (P <0.001, FSA). In the lateral compartment, FDs calculated for OA trabeculae were lower than controls (horizontal: 0.3–0.55 mm (P <0.05, HOT) and 0.3–0.65 mm (P <0.001, FSA); vertical: 0.3–0.4 mm (P <0.05, HOT) and 0.3–0.35 mm (P <0.001, FSA). Conclusion: The augmented HOT method produces fractal signatures that are comparable to those obtained from the benchmark FSA method. The HOT method provides a more detailed description of OA changes in bone anisotropy than the FSA method. This includes a degree of bone anisotropy measured using data from all possible directions and a texture roughness calculated for the roughest part of the bone. It appears that the augmented HOT method is well suited to quantify OA changes in the tibial bone structure.