An age-related medullary expansion can have implications for the long-term fixation of hip prostheses

Abstract

Background Diaphyseal bone loss occurs mainly at the endosteal surface in the medullary cavity. Since the menopause is followed by an increase in bone loss, the size of the medullary cavity should theoretically increase during the postmenopausal period. If so, this might affect the long-term fixation of hip prostheses.Patients and methods This 19-year prospective study evaluated bone loss and geometrical changes in 112 women, all premenopausal at baseline. Bone mineral density (BMD) and skeletal geometry, with special reference to the size of the medullary cavity, were estimated every other year by single-photon absorptiometry at the cortical site of the distal radius.Results After menopause, a decrease of 1.7 (95% Cl 1.6-1.8)% occurred in the BMD every year, while an increase of 0.9 (0.8-1.0)% in the medullary width (endosteal width) too place every year. The annual change in BMD was inversely correlated with the annual change in the medullary width (r = -0.5, p < 0.001). The quartile of women with the largest BMD loss had a greater medullary expansion than the quartile of women with the least BMD loss (p < 0.001).Interpretation If the age-related expansion of the radial medullary cavity is a general phenomenon, this may have implications for the long-term fixation of hip prostheses.

Signalment differences in bone mineral content and bone mineral density in canine appendicular bones

“…In humans, height was not significantly correlated with BMD in young women (12) but with total body BMC in men and women (5). With regard to the influence of age, diaphyseal bone loss has been detected in women after the menopause, resulting in an expansion of the medullary cavity of the radius (13). In veterin-ary medicine, the increase in BMC from youth to adulthood in cats (14) and dogs (2) was comparable to our results.…”

Femoral cortical index: an indicator of poor bone quality in patient with hip fracture

“…It is well known that with osteoporosis advancement, widening of the endosteal diameter and thinning of the cortices over the diaphyseal region of the long bones can be observed in plain radiograph [23]. Ahlborg et al had been following 112 women who were premenopausal at baseline for 18 years [24]. They reported that BMD decreased by 1.7 % per year and the endosteal diameter increased by 0.9 % per year after menopause.…”

Radiographic study of the proximal femur morphology of elderly patients with femoral neck fractures: is there a difference among ethnic groups?

“…BMD loss was reported to show significant correlation with expansion of the medullary canal. (14) We hypothesised that the CC ratio may not vary considerably between non-osteoporotic and osteoporotic bone, as it is the ratio of two endosteal diameters.…”