Cancellous bone changes in hip osteoarthritis: a short-term longitudinal study using fractal signature analysis

Abstract

The increased thickness of the larger trabeculae within the compressive structural element of the femoral head is a response to the increase in stress associated with an overall loss of trabeculae in this region, suggesting the presence of an osteoporosis within the femoral head in OA patients.

Comparative high-resolution pQCT analysis of femoral neck indicates different bone mass distribution in osteoporosis and osteoarthritis

“…Therefore, these findings are in agreement with recent observations that OA is not associated with an increase in volumetric BMD as assessed by pQCT of the tibia in vivo [35], and that postmenopausal women affected by OA at the hip are not protected from osteoporosis [12]. A significant proportion of patients with end-stage OA have osteoporosis and/or osteopenia, but this diagnosis may be missed unless BMD measurements are performed by DXA at sites distant from joints affected by osteoarthritis [11,36,37], or by microradiographs [8] or pQCT [35,38]. Several longitudinal and prospective observations have indicated that bone loss does occur in OA [39] and even at faster rate than in normal controls [13].…”

“…The compensatory mechanism aimed to maintain the biomechanical strength of the bone in OA fits observations that the decrease in trabecular number in OA due to the osteoporotic process is associated with increased trabecular thickness at the proximal femur [7,8] and in the knee [14], and that the OA-affected side is characterized by higher bone mineral content and a larger area than the contralateral side [12]. However, these observations do not fully dissect the differential involvement of the cortical and trabecular compartments in determining the reduced fracture risk in the femoral neck of OA patients and do not establish the effectors of the adaptive mechanisms, i.e., geometry, density, and/or mass distribution.…”

“…Accordingly, higher bone mass density (BMD) was previously found in the femoral necks of twins with OA compared to their co-twins without OA [6]. Accumulating evidence suggests that patients with primary OA and OP represent morphologically different populations with characteristic trabecular bone architecture responsible for their inverse relationships [7][8][9]. However, the relationship between these two common, age-related disorders remains controversial [10], as it is much more complex than commonly believed.…”

Changes in proximal femoral mineral geometry precede the onset of radiographic hip osteoarthritis: The study of osteoporotic fractures

“…This lies within the metabolically active trabecular compartment and originates from the superior femoral neck cortex, along the epiphyseal scar to the pressure buttress of the medial femoral neck the densest structure in the region [26]. This is supported by studies using macro-radiographs of the hip, describing increases in the thickness of the vertical trabeculae of the compressive strut in hips with OA [27]. In these studies there also appears to be a thinning of the remaining trabecula, suggesting a redistribution of mineral within the trabecular compartment in response to altered loads [28].…”

La géométrie fractale pour l’analyse de signaux médicaux : état de l’art

“…Ces dernières années, les recherches concernant la caractérisation de la trabéculation osseuse par l'intermédiaire de l'analyse fractale, sont restées très dynamiques [117,132,190,193]. Plusieurs travaux se sont intéressés à l'anisotropie de la trabéculation osseuse [13].…”