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PubMed2002

Radiographic methods in knee osteoarthritis: a further comparison of semiflexed (MTP), schuss-tunnel, and weight-bearing anteroposterior views for joint space narrowing and osteophytes.

OBJECTIVE: Current radiographic evaluation of knee osteoarthritis (OA) depends primarily on the presence and severity of joint space narrowing (JSN) and osteophytes. Radiographic JSN is a function of the actual JSN caused by articular cartilage loss and the observable JSN artifactually caused when the tibial and femoral surfaces diverge due to variations in patient's knee position. Views yielding the greatest JSN are the most accurate. Osteophytes are also dependent on positioning. This study investigated the consequences of positioning on JSN and osteophytes in clinical studies in which the outcome of OA knee is scored. METHODS: In total, 1105 patients underwent 1175 paired radiographic examinations using weight-bearing (WB) standard anterior-posterior (AP) extended knee views (AP-WB), semiflexed WB posterior-anterior views with the knee in contact with the film and the 1st metatarsophalangeal (MTP) joint under the film plane (MTP) (method of Buckland-Wright), and WB PA views with the tip of the great toe at the film plane, 20 degrees of knee flexion and 5 degrees downward angulation of the x-ray tube (schuss-tunnel view). Careful attention was given to proper positioning. JSN and osteophytes were scored on a 0-3 scale. RESULTS: JSN was significantly greater by the MTP and schuss-tunnel methods than by the AP-WB method, but no difference was found between the MTP and schuss-tunnel methods. In addition, disagreement was identified in 34% of MTP and AP-WB scores. In 69.3% of disagreements the scores were more abnormal in the MTP view. When the disagreements were studied, the mean MTP score was 1.68 compared to 1.12 for the AP-WB score. Fifty-seven knees were scored as 3 by the MTP view and as 2 by the AP-WB, and 8 knees were scored as 3 by the AP-WB view and 2 by the MTP view. Little difference in osteophytes was noted among the 3 methods, although fewer osteophytes were identified by the schuss-tunnel method than the AP-WB method. CONCLUSION: Using the clinical reading methods of this study, the MTP and schuss-tunnel views were equivalent when compared to each other. When compared with the AP-WB view, the schuss-tunnel view resulted in a lower osteophyte score. These results, based on clinical readings, are similar to previous computerized analyses that indicated that the MTP and schuss-tunnel views were superior to the AP-WB, but that the MTP view was superior to the schuss-tunnel view.

Arthrography↗
PubMed1995

Differential expression of collagen types I, II, III, and X in human osteophytes.

BACKGROUND: Osteophytes are neoplastic cartilaginous and osseous protrusions growing at the margins of osteoarthritic joints. Their formation involves complex patterns of cellular proliferation, differentiation, as well as matrix synthesis and turnover that are poorly understood. EXPERIMENTAL DESIGN: Here we report on an experimental approach using in situ hybridization and immunohistology to elucidate pathways of chrondrocyte differentiation in human osteophytes. Ab and cDNA probes for collagen types were used as specific parameters for chondrocyte phenotypes. RESULTS: In early precartilaginous mesenchymal tissue, cytoplasmic mRNA for alpha 1(I) and alpha 1(III) collagen genes (Col1A1 and Col3A1) were found by in situ hybridization, correlating with the distribution of type I and III collagen as revealed by Ab staining. Strong expression of type II collagen both at mRNA and protein levels was the hallmark of chondrogenic differentiation in the cartilaginous zone of osteophytes. Type II collagen expression increased in all cartilaginous and fibrocartilaginous areas with growth and maturation of osteophytes. The signal intensity obtained after in situ hybridization with a COL2A1 probe was high and corresponded to that obtained in fetal cartilage, whereas normal adult articular cartilage usually did not show measurable type II collagen expression. In fibrocartilaginous areas, the most abundant, but heterogeneous tissue type seen in osteophytes, type II and III collagen mRNA expression overlapped considerably. Type III collagen was scattered, both pericellularly and interterritorially, over the whole osteophyte, excluding bone and chondrocytic cells of the deep zone. The strongest type I collagen expression was seen in bone and in the superficial fibrous layer. In areas of endochondral ossification, large chondrocytes were found expressing type X collagen, a specific marker for hypertrophic chondrocytes. CONCLUSIONS: These results show that discrete stages of cartilage differentiation can be precisely followed in osteophytes using collagen type-specific cDNA probes and Ab as markers. In addition, a fibrocartilaginous chondrocyte phenotype was identified that expresses type II and III, but not type I collagen.

Aged↗
PubMed2003

Prevalence of osteophytes associated with the acromion and acromioclavicular joint.

Osteophytes as a stigma for shoulder impingement syndrome and osteoarthritis of the acromioclavicular (AC) joint were studied on the acromions and AC joints in 346 skeletons (230 males; 116 females), ranging in age from 15-100 years. Osteophytes were found on 28.9% (200/692) of the acromions, mostly on the anteroinferior aspect (54%; 108/200). Of these 28.9%, 87% (174/200) were of the traction type and 13% (26/200) of the claw type. Regarding the clavicles, 11.6% (80/692) had osteophytes on the articular facets of their lateral ends; all were of the traction type. There were statistically more osteophytes on the right than on the left side of both acromion and clavicle (P < 0.05). The occurrence of osteophytes and increasing age were significantly correlated (r = 0.65, P < 0.001). No gender differences were noted in the frequency of osteophytes on acromions or clavicles. These data should prove beneficial to clinicians in planning a proper course of treatment for patients suffering from painful conditions of the shoulder.

Acromioclavicular Joint↗
PubMed2006

Is the degree of osteophyte formation associated with the symptoms and functions in the patellofemoral joint in patients undergoing total knee arthroplasty?

Osteophyte formation and loss of articular cartilage are the main pathologic features of osteoarthritis in the patellofemoral joint. The goal of this study was to determine whether the degree of osteophyte formation was associated with the degree of cartilage loss and the patellofemoral symptoms and functions in osteoarthritic patients undergoing total knee arthroplasty (TKA). We evaluated 71 knees in 54 consecutive patients who underwent TKA under the diagnosis of osteoarthritis. The degree of patellofemoral osteophyte formation was assessed by proportional diameter and proportional rim involvement. The cartilage status was assessed by depth and size of the cartilage lesion. The patellofemoral symptoms and functions included anterior knee pain, abilities of chair-rising and stair-climbing and quadriceps muscle power. No significant association was found between the degrees of patellar or trochlear osteophyte formation with anterior knee pain or any of the patellofemoral functional parameters (P>0.05). The degree of osteophyte formation in the patella and the trochlea had a significant but weak correlation with the status of patellar cartilage and the status of the trochlear cartilage, respectively (correlation coefficient = 0.22-0.41 and P<0.05). This study indicates that physicians need to be cautious not to easily reach the conclusion that the patellofemoral symptoms and functional disabilities can be attributed to the presence of osteophyte in the patellofemoral joint in consulting patients with the patellofemoral radiographs or deciding on patellar resurfacing in TKA.

Aged↗
PubMed2005

How do marginal osteophytes, joint space narrowing and range of motion affect each other in patients with knee osteoarthritis.

To assess the number, location, direction and size of osteophytes and the change of the joint space width (JSW) in radiographs of the tibiofemoral (TF) joint in middle-aged people with longstanding knee pain with radiographic osteoarthritis (OA), and to correlate between the range of motion (ROM). In the format of a retrospective study, the OA of both knee in 84 people, 8 men and 76 women (aged 42-77 years), with chronic knee pain at inclusion were examined. The JSW of the TF joint and the number, location, direction and size of osteophyte were evaluated using a PA view in weightbearing. The location and direction of osteophytes showed some variation at each site, particularly at the lateral tibial plateau and medial femoral trochlea. Significant correlations were found between ROM of the right and left knee and the size, location and direction of the most osteophytes. In both knees, the JSW medially was lower when compared with the lateral compartment. The mean JSW in the lateral tibiofemoral compartment of the right knee was associated with active and passive flexion degree of the patients. The mean JSW in the medial and lateral tibiofemoral compartment of the left knee correlated with BMI, and changes in the Kellgren and Lawrence grade of the patients. There was found statistically significant correlation between mechanical medial proximal tibial angle and the osteophyte size of the right and left knee. We think that definitions which incorporate both osteophytes and joint space narrowing offer the association with worsening of active and passive ROM.

Adult↗
PubMed2003

PTHrP, PTHr, and FGFR3 are involved in the process of endochondral ossification in human osteophytes.

To elucidate the process of endochondral ossification in human osteophytes we have studied the expression of parathyroid hormone-related protein (PTHrP), its receptor (PTHr), and fibroblast growth factor receptor 3 (FGFR3). Osteophytes from patients undergoing total knee replacement ( n=13), and fetal growth plate cartilages ( n=4) were processed for safranin O staining and immunohistochemistry. Chondrocytes and their matrix were preferentially stained for PTHrP in the middle and deep zones of the osteophytes examined. Ossified areas did not show a positive staining. In fetal joints the cartilaginous surface and the perichondrium as well as the osteoblasts in the trabecular bone were positive. PTHr was expressed at large in chondrocytes and osteoblasts of all osteophytes and fetal joints. Cells of the perichondrium were also positive. The FGFR3 antibody stained only single chondrocytes in some osteophytes, and groups of cells in others. In fetal samples, chondrocytes of the proliferating and the hypertrophic zone showed staining for FGFR3. This is the first report on the expression of PTHrP, PTHr, and FGFR3 in human osteophytes. As in fetal joints these mediators might regulate proliferation and differentiation of chondrocytes playing an important role in osteo(chondro)phyte growth.

Aged↗
PubMed2004

Synovial lining macrophages mediate osteophyte formation during experimental osteoarthritis.

OBJECTIVE: In human osteoarthritis (OA), various forms of pathology are observed. Besides cartilage damage and fibrosis, neogenesis of bone, osteophyte formation, also occurs. Osteophytes are thought to limit joint movement and cause pain. The objective of this study was to investigate whether synovial macrophages are involved in osteophyte formation in experimental OA, and if they are, to study which mechanism may be involved. DESIGN: Experimental OA was induced by two intra-articular injections of collagenase on alternate days into murine knee joints. The role of synovial lining macrophages in this model was studied by selective removal of these cells prior to OA induction using clodronate liposomes. After 1 and 2 weeks, knee joints were dissected and examined (immuno)histologically. RESULTS: At days 7 and 14 after induction of OA, osteophyte formation and fibrosis were observed. Depletion of synovial macrophages resulted in spectacular reduction of osteophyte formation, 84% and 66%, respectively, at days 7 and 14. Fibrosis and synovial activation, measured by MRP8/14 expression, were also ameliorated (40-60%). In addition, production of growth factors (TGFbeta, BMP-2 and BMP-4) in the lining was largely prevented but production of these growth factors in deeper layers of the synovium and the periosteum did not differ from controls. CONCLUSIONS: These results indicate the synovial macrophage to be a pivotal cell in the synovium mediating osteophyte formation and other OA-related pathology, like fibrosis, during experimental OA. Production of growth factors and induction of synovial activation by these cells may play a crucial role in this event.

Animals↗
PubMedDate not supplied

Glenoid osteophyte and rotator cuff tears: an anatomic study.

The purpose of this study was to determine the morphologic characteristics of the glenoid osteophyte and its relationship to rotator cuff tears. Eighty-six cadaveric shoulders were studied. After inspection of cuff pathology, the glenoid was examined with soft x-rays. Histologically, degenerative changes of the articular cartilage and the labrum were assessed. There were 30 shoulders with rotator cuff tears (35%). Two types of glenoid osteophyte were identified: angular and hooked. Both osteophytes were commonly observed in the anterior to inferior portions of the glenoid. The length of hooked osteophytes was significantly greater in shoulders with full-thickness tears (2.7 +/- 2.2 mm [mean plus minus SD]) than in those with other cuff conditions (P =.0058). The hooked osteophyte was more commonly observed in shoulders with full-thickness tears (43%) and associated with degenerative changes of the cartilage and labrum. We conclude that the hooked osteophyte of the glenoid is characteristic in shoulders with full-thickness tears of the rotator cuff.

Adult↗
PubMed1992

Posttraumatic anterior cervical osteophyte and dysphagia: surgical report and literature review.

Degenerative changes in the cervical spine can produce osteophytes and other hypertrophic abnormalities. Asymptomatic osteophytes of the anterior margins of the cervical vertebrae may occur in 20-30% of the population. Occasionally, dysphagia or dysphonia may be caused by such cervical osteophytes pressing against the esophagus or trachea. Recently, the authors treated a patient with posttraumatic dysphagia and dysphonia secondary to osteophytic spurring of the anterior cervical spine. This 43-year-old man presented 2 years after sustaining a flexion/extension soft tissue injury to his cervical spine. Radiographic studies depict the progression of his osteophyte growth, which resulted in surgical intervention to relieve his inability to swallow solid foods. One year follow-up studies demonstrate normal alignment and no instability. A search of the literature revealed approximately 75 previously reported cases of anterior osteophyte-induced dysphagia, with the majority secondary to diffuse idiopathic skeletal hyperostosis. The literature briefly mentions trauma as a possible etiology of anterior osteophytosis; however, our case is unique, as it documents the time course and progression of the pathologic process.

Adult↗
PubMed1991

The influence of osteophytes and aortic calcification on spinal mineral density in postmenopausal women.

The assessment of vertebral bone mineral density (BMD) in the anterio-posterior projection has become widely used in the management and prevention of osteoporosis. Recently, it has been demonstrated that the presence of spinal osteophytes has a major impact on measured BMD in men, thus casting doubt on the value of these BMD measurements. We have assessed the impact of osteophytic and aortic calcification on spinal and femoral BMD measurements in 130 normal postmenopausal women, aged 45-71 yr. Lateral lumbar spine radiographs were obtained in all subjects and graded separately (0-3) for osteophytes and aortic calcification. Both forms of calcification increased with age, and BMD of all sites was correlated positively with body weight and negatively with age. The correlation coefficients between BMD and calcification scores were nonsignificant. Multiple regression analysis, including weight, age, and calcification scores, demonstrated a small but significant effect of osteophyte score on lumbar BMD (partial r2 = 0.04; P = 0.012) and a similar trend for Ward's triangle and the trochanteric region (partial r2 = 0.02; P less than 0.06). The aortic calcification score remained nonsignificant. It is concluded that the influence of spinal osteophytes on lumbar BMD in postmenopausal women is substantially less than that in men and is, therefore, unlikely to interfere with BMD estimation in most subjects. The relationship between proximal femoral BMD and osteophyte score suggests a real relationship between skeletal density and degenerative joint disease, as has been demonstrated by others.

Aged↗
PubMed2001

The position and shape of osteophyte formations at canine vertebral endplates and its influence on radiographic diagnosis.

The relationship between the risk of missing osteophytes in lateral radiographs and their position was determined in a sample of German shepherd dogs (GSDs, n = 42) and dachshunds (DHs, n = 36). Only 10% of osteophytes which were not detected on radiographs were located in the ventral median area (position 1) and classified as type 1 (small spur with narrow base). The highest risk for being affected next to the intervertebral foramen and/or the dorsal area of the vertebral endplate (position 3) was noticed in the lumbar segment (95% CI: 5.2-9.8% in DHs; 11.9-17.7% in GSDs). The minimum risk of missing osteophytes in this position radiologically was 33.3% in the GSDs and 26.4% in the DHs. In the GSDs a higher proportion of type 2 osteophytes (spur with broader base of origin, tending to extend up to half the way along the disc space) was not visualized on radiographs. Peak incidences of osteophytes in positions 1 and 3 were located at the centres of spinal flexion and extension. Therefore, distribution patterns of osteophytes in these positions confirmed mechanical factors being important in pathogenesis of vertebral osteophytosis.

Animals↗
PubMed1986

[Histopathological studies of the osteophytes and ossification of the posterior longitudinal ligament (OPLL) in the cervical spine].

To obtain information on ossification around the vertebral body of the cervical spine, we carried out histopathological investigation on 30 autopsy cases. The results were as follows; Intervertebral discs were untouched, anterior osteophytes developed along the anterior longitudinal ligament and they corresponded to anterior spur in spondylosis deformans. Posterior osteophytes around the posterior edges of vertebral body resulted in intervertebral insufficiency, and corresponded to hypertrophic spur in osteochondrosis. Histopathological findings of hyperostotic anterior osteophytes were similar to anterior osteophytes, but in the former there were advanced osteophyte formations. In OPLL of the segmental type, intervertebral discs were degenerated, and ossified mass did not involve the posterior longitudinal ligament of the parts of discs. With regard to morphological appearance and the tendency of increasing ossification, OPLL of the continuous type was similar to hyperostotic anterior osteophytes, without involvement of intervertebral disc. OPLL of the distinctly continuous type was differentiated from that of the segmental type.

Adult↗
PubMed1985

[The natural course of osteoarthritis of the hip. Indication of conservative treatment in relation to osteophyte formation at the acetabular rim].

One hundred and eighty-five hips from 152 patients with primary or secondary osteoarthritis were studied in an attempt to assess the degrees of hip pain in contrast to radiological and other clinical findings. In 30.8% and 26.4% of the primary and secondary osteoarthritic hips respectively, hip pain showed some gradual decrease as time elapsed. Pain relief probably in association with osteophyte formation at the craniolateral acetabular rim occurred in 62.5% and 33.3% of the primary and secondary osteoarthritic hips respectively. Significant parameters observed in the primary osteoarthritic cases of the decreasing pain group were as follows: A lesser extent of cranial displacement of the femoral head, poor capital drop development, well developed floor osteophyte. On the other hand significant parameters in the decreasing pain group of secondary osteoarthritis were as follows: Well developed floor osteophyte, a small size of cyst in both the femoral head and the acetabulum, few "b" or "d" type of bony sclerosis in the acetabulum. Careful observation of radiographic changes (cyst and sourcil) would be most important, especially in secondary osteoarthritis, to decide the indication of surgery. On the basis of histological studies of osteophyte at the craniolateral acetabular rim obtained at the operation, it was assumed that the osteophyte formation had initiated from metaplasia of the labrum or synovial membrane and progressed by a form of chondral ossification after the process of fibrous tissue formation. A well developed trabecular density in the osteophyte at the craniolateral acetabular rim was determined by the use of Muto digigrammer system, Model G-002.

Acetabulum↗
PubMed1994

Transforming growth factor-beta 1 stimulates articular chondrocyte proteoglycan synthesis and induces osteophyte formation in the murine knee joint.

BACKGROUND: High concentrations of active transforming growth factor-beta (TGF-beta) have been found in synovial fluids from arthritic joints. TGF-beta stimulates articular cartilage proteoglycan synthesis and suppresses proteoglycan degradation in vitro. In an earlier study, we found no effect on cartilage proteoglycan metabolism shortly after a single intra-articular injection of TGF-beta 1. In the present study, we used multiple intra-articular injections and a longer time-scale. EXPERIMENTAL DESIGN: TGF-beta 1 was injected into the murine knee joint to gain insight in the consequences of its overproduction in joint diseases. This was evaluated using histologic sections of the whole knee joint and measurements of articular cartilage proteoglycan synthesis and content. RESULTS: At 6 hours after a single TGF-beta 1 injection, recruitment of polymorphonuclear leukocytes (PMNs) was observed. After 24 hours, the amount of inflammatory cells had already decreased. Multiple TGF-beta 1 injections induced synovial hyperplasia and synovitis predominantly consisting of cells of the macrophage/monocyte lineage. Both single and multiple TGF-beta 1 injections induced strong and long-lasting stimulation of articular cartilage proteoglycan synthesis. This in vivo stimulation of proteoglycan synthesis was similar in cartilage of young (3 months) and old mice (18 months). Multiple TGF-beta 1 injections resulted in an increased GAG content in patellar cartilage. After triple TGF-beta 1 injections, impressive osteophyte formation was noted at specific sites. The size and the localization of osteophytes was identical in young and old mice. Interestingly, the localization of TGF-beta 1-induced osteophytes was very similar to that of osteophytes observed in experimental arthritis and osteoarthritis models, suggesting a role for endogenous TGF-beta in osteophyte formation during joint pathology. CONCLUSIONS: Our data indicate that TGF-beta 1 injection into a normal joint induces inflammation, synovial hyperplasia, osteophyte formation, and prolonged elevation of proteoglycan synthesis and content in articular cartilage.

Animals↗
PubMed2003

Reduction of osteophyte formation and synovial thickening by adenoviral overexpression of transforming growth factor beta/bone morphogenetic protein inhibitors during experimental osteoarthritis.

OBJECTIVE: Osteoarthritis (OA) is a joint disease characterized by osteophyte development, fibrosis, and articular cartilage damage. Effects of exogenous transforming growth factor beta (TGFbeta) isoforms and bone morphogenetic proteins (BMPs) suggest a role for these growth factors in the pathogenesis of OA. The aim of this study was to elucidate the role of endogenous TGFbeta and BMP during papain-induced OA-like changes in mice. METHODS: We used adenoviral overexpression of TGFbeta and BMP antagonists to block growth factor signaling. An adenovirus expressing a secreted, pan-specific TGFbeta antagonist called murine latency-associated peptide 1 (mLAP-1) was used. In addition, we used intracellular inhibitory Smad6 as a BMP antagonist and Smad7 as a TGFbeta/BMP inhibitor. Papain was injected into the knee joints of C57BL/6 mice to induce osteophyte development, synovial thickening, and articular cartilage proteoglycan (PG) loss. RESULTS: Intraarticular injection of papain caused increased protein expression of several TGFbeta and BMP isoforms in synovium and cartilage. Adenovirus transfection into the joint resulted in a strong expression of the transgenes in the synovial lining. Overexpression of mLAP-1, Smad6, and Smad7 led to a significant reduction in osteophyte formation compared with that in controls. Smad6 and Smad7 overexpression also significantly decreased synovial thickening. Furthermore, the secreted TGFbeta inhibitor mLAP-1 increased articular cartilage PG loss. CONCLUSION: Our results indicate a pivotal role of endogenous TGFbeta in the development of osteophytes and synovial thickening, implicating endogenous TGFbeta in the pathogenesis of OA. In contrast, the prevention of cartilage damage by endogenous TGFbeta signifies the protective role of TGFbeta in articular cartilage. This is the first study to demonstrate that endogenous BMPs are involved in osteophyte formation and synovial thickening in experimental OA.

Adenoviridae↗
PubMed1998

Cervical osteophytic dysphagia: single and combined mechanisms.

Cervical osteophytes are common in the aging population. Dysphagia induced by cervical osteophytes, although uncommon, is an important and treatable cause of dysphagia that must be identified during the modified barium swallow. Previous authors have described osteophyte impingement as a cause for dysphagia. This report describes a case of this classic obstructive osteophytic dysphagia and one of combined osteophytic and neurogenic dysphagia. This is the first time that a combined mechanism is described in the literature.

Aged↗
PubMed2002

Involvement of sensory nerves and immune cells in osteophyte formation in the ankle joint of adjuvant arthritic rats.

To study the mechanism of osteophyte formation in the ankle joints of adjuvant arthritic (AA) rats, the localization of peripheral nerves and immune cells in the synovia were investigated in both axotomized AA rats, whose sciatic nerves were resected before adjuvant injection, and sham-operated ones, using immunohistochemistry for low-affinity nerve growth factor receptor (p75NGFR), growth-associated protein (GAP)-43, calcitonin gene-related peptide (CGRP), helper T cell (W3/25), monocyte/macrophage (ED1), and transforming growth factor (TGF)-beta1 and its receptor, TGF-betaRII. In sham-operated AA rats, dense plexuses of CGRP-positive fibers were observed in the inflamed synovia close to the osteophytes. Most of the CGRP-positive fibers were also positive for p75NGFR and GAP-43. These fibers appeared to be newly sprouted sensory nerves. In axotomized AA rats, the synovia were supplied with no CGRP-positive fibers and the sizes of the osteophytes were smaller than those in sham-operated animals. The ratio of the number of both W3/25- and ED1-positive cells in the inflamed synovia of sham-operated rats peaked at weeks 2-3 after adjuvant injection. The peak, however, lasted until week 4 in axotomized ones. In both animal groups, the macrophages and the osteoblasts were stained for TGF-beta1. The osteoblasts covering the osteophytes were also stained for TGF-betaRII. The present findings suggest that the sensory nerves and the macrophages may be involved in osteophyte formation in the ankle joints of AA rats.

Animals↗
PubMed2005

The numerical simulation of osteophyte formation on the edge of the vertebral body using quantitative bone remodeling theory.

OBJECTIVES: To extend the quantitative prediction of the external shape of bone structure to the simulation of osteophyte formation on the edge of vertebral body. METHODS: The high-order nonlinear equation of bone remodeling was used to control osteophyte formation process. The idea of topology optimization in engineering was imported to allow the outgrowth of osteophyte. Osteophyte on the edge of a vertebral body in its mid-sagittal plane was simulated numerically. RESULTS: Osteophyte formation is an adaptive bone remodeling process in response to the progressive changes of mechanical environment, which were mainly caused by intervertebral disc degeneration. CONCLUSION: The numerical simulation in this paper extended the structural simulation based on the quantitative bone remodeling theory to bone morphological abnormity in orthopaedics, which can help to better understand the relationship between bone morphological abnormity and the mechanical environment.

Bone Density↗