A μCT analysis of the femoral bone stock in osteonecrosis of the femoral head compared to osteoarthrosis

Beckmann, Johannes; Matsuura, Maiko; Grässel, Susanne; Köck, F. X.; Grifka, Joachim; Tingart, Markus

doi:10.1007/s00402-008-0666-y

Cited by 12 publications

(10 citation statements)

References 32 publications

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“…The sample size of the study is modest but keeping in the context of non-traumatic ON, contrary to many studies 17, 25, 36, 37 , a control group was provided and the population size of the control group was larger than observed in most similar studies 15, 33, 35 . Age-related increase of crystallinity (and to some extent the decrease of the proteoglycan content) was an expected between-group difference 38 and was confirmed by multivariate analysis.…”

Section: Discussionmentioning

confidence: 91%

“…Several studies looked into potential modifications of the trabecular architecture of human or animal femoral heads undergoing or having undergone osteonecrosis. Two studies compared the remaining “healthy” trabecular bone using micro-computed tomography of human osteonecrotic femoral heads versus osteoarthritic controls and none of them found differences 33, 34 . The same results were found in a model of corticosteroid-induced ON of the femoral head in bipedal emus 35 .…”

Section: Discussionmentioning

confidence: 99%

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Region specific Raman spectroscopy analysis of the femoral head reveals that trabecular bone is unlikely to contribute to non-traumatic osteonecrosis

Pascart

Falgayrac

Migaud

et al. 2017

Sci Rep

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Non-traumatic osteonecrosis (ON) of the femoral head is a common disease affecting a young population as the peak age of diagnosis is in the 40 s. The natural history of non-traumatic ON leads to a collapse of the femoral head requiring prosthetic replacement in a 60% of cases. Although trabecular bone involvement in the collapse is suspected, the underlying modifications induced at a molecular level have not been explored in humans. Here, we examine changes in the molecular composition and structure of bone as evaluated by Raman spectroscopy in human end-stage ON. Comparing samples from femoral heads harvested from 11 patients and 11 cadaveric controls, we show that the mineral and organic chemical composition of trabecular bone in ON is not modified apart from age-related differences. We also show that the molecular composition in the necrotic part of the femoral head is not different from the composition of the remaining ‘healthy’ trabecular bone of the femoral head. These findings support that quality of trabecular bone is not modified during ON despite extensive bone marrow necrosis and osteocyte death observed even in the ‘healthy’ zones on histological examination.

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Region specific Raman spectroscopy analysis of the femoral head reveals that trabecular bone is unlikely to contribute to non-traumatic osteonecrosis

Pascart

Falgayrac

Migaud

et al. 2017

Sci Rep

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“…We cannot exclude possible differences in collagen I production or degradation at earlier stages which are attenuated during progression of the diseases. Along this line, μCT analysis of structural bone parameters fail to reveal differences between OA and ONFH affected head and neck bone biopsies at this late stage of the diseases (26,39).…”

Section: Discussionmentioning

confidence: 99%

Expression profile of matrix metalloproteinase-2 and -9 and their endogenous tissue inhibitors in osteonecrotic femoral heads

Grässel

Beckmann²,

Rath³

et al. 2010

Int J Mol Med

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Abstract. The pathogenetic mechanisms of osteonecrosis of the femoral head are unresolved to date. This study analyzed the matrix metalloprotease (MMP) and tissue inhibitor of matrix metalloprotease (TIMP) expression and activity which might add to the impaired bone matrix repair capacity affecting the balance between bone resorption and de novo bone formation in osteonecrosis of the femoral head (ONFH). Cancellous bone biopsies were taken at the femoral head and neck of patients with advanced ONFH and patients with primary osteoarthritis (OA) who were undergoing total hip arthroplasty. We assessed the gene expression levels of MMP-2 and -9, TIMP-1 and -2, IL-1ß, IL-6 and TNF-· in both biopsies. These data were corroborated by MMP activity screening, collagen profiling and ELISAs for determination of MMP, TIMP, IL-1ß, IL-6 and TNF-· concentrations. Gene expression rates of MMP-2 and TIMP-1 were higher in ONFH biopsies whereas TIMP-2 and MMP-9 gene expression was not significantly altered. MMP protein profile shifted towards increased biosynthesis of both, active and pro-MMP-2 in ONFH bone lysates and decreased pro-MMP-9 production. Expression profiles of pro-inflammatory cytokines and collagens in OA and ONFH bone lysates were highly similar. Increased biosynthesis and activation of MMP-2 in ONFH samples may add to shifting the bone matrix turnover balance towards resorption of bone macromolecules thereby counteracting new bone matrix production. OA-and ONFH-affected bone exhibits a similar pro-inflammatory cytokine and collagen expression profile suggesting a relationship on the molecular level of inflammation and collagenous matrix composition between both diseases.

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“…In another study, Beckman et al analyzed the bone quality and 3-dimensional microarchitecture of the femoral head and neck in patients with ON of the femoral head, and compared them to a group of patients with primary osteoarthritis [30]. They found no statistically significant differences in bone volume and bone volume fraction, connectivity density and the structure model index in patients with ON of femoral head and those with OA.…”

Section: Discussionmentioning

confidence: 99%

Total hip arthroplasty in advanced osteonecrosis: The short-term results by metal-on-metal hip resurfacing

et al. 2011

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SummaryBackgroundCharacteristically, osteonecrosis affects younger patients who typically refer to the orthopedic surgeon for the first time in the third to fifth decades of life, in the late stages of the disease. Femoral metal-on-metal hip resurfacing is as an alternative to conventional total hip arthroplasty in treating osteoarthritis of the hip. Since there are already many reports regarding the successful outcome of resurfacing in advanced osteoarthritis, the purpose of this study was to analyze the clinical outcomes of this procedure in patients with osteonecrosis of the femoral head and to compare them with a matched group of patients with osteoarthritis.Material/MethodsThis retrospective cohort study evaluated a consecutive series of 52 patients with end-stage osteonecrosis (28 patients) and osteoarthritis (24 patients) of the femoral head, managed by metal-on-metal hip resurfacing in a referral orthopedic center from Feb 2002 to May 2007. Pain, function and deformity were evaluated with the use of the Harris hip score after the operation. Patients were clinically followed for a mean of 41 months.ResultsThe patients in the osteoarthritis group had a significantly higher mean age than those in the osteonecrosis group (47.88±12.6 vs 30.86±7.5, p=0.003).The clinical outcomes were similar for both groups. There was no significant difference in mean Harris hip score (p=0.347) and hip joint range of motion (p=0.346) between osteonecrosis and osteoarthritis groups after surgery.ConclusionsOn the basis of these initial findings, we recommend MOM resurfacing as a viable treatment option for patients with advanced stages of osteonecrosis.

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A μCT analysis of the femoral bone stock in osteonecrosis of the femoral head compared to osteoarthrosis

Cited by 12 publications

References 32 publications

Region specific Raman spectroscopy analysis of the femoral head reveals that trabecular bone is unlikely to contribute to non-traumatic osteonecrosis

Region specific Raman spectroscopy analysis of the femoral head reveals that trabecular bone is unlikely to contribute to non-traumatic osteonecrosis

Expression profile of matrix metalloproteinase-2 and -9 and their endogenous tissue inhibitors in osteonecrotic femoral heads

Total hip arthroplasty in advanced osteonecrosis: The short-term results by metal-on-metal hip resurfacing

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