Comparison of 2D and 3D bone microarchitecture evaluation at the femoral neck, among postmenopausal women with hip fracture or hip osteoarthritis

Boutroy, Stéphanie; Vilayphiou, Nicolas; Roux, Jean-Paul; Delmas, Pierre D.; Blain, Hubert; Chapurlat, Roland; Chavassieux, Pascale

doi:10.1016/j.bone.2011.07.037

Cited by 35 publications

(25 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Because the distribution of compressive and tensile forces through the talus does not severely change with age, we speculate that the differently sized volumes of interest might be responsible for the greater bone loss in the body [34]. At first glance, the nearly unimpaired bone structure of the talar neck seemed contradictory given that the femoral neck has a similar weight-transmitting function and an age-related degradation of the femoral neck was reported [10,12]. Age-related cortical trabecularization and thinning were attributed to a higher risk of hip fracture in the elderly [9,10].…”

Section: Discussionmentioning

confidence: 98%

Bone Microarchitecture of the Talus Changes With Aging

Krause

Rupprecht

Mumme

et al. 2013

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Background Fractures of the talus in the elderly are rare and usually result from high-impact injuries, suggesting only minor age-related bone structure changes. However, total ankle replacement failures with age often result from talar subsidence, suggesting age-related bone loss in the talus. Despite a number of histological analyses of talar microarchitecture, the effects of age and sex on talar microarchitecture changes remain poorly defined.Questions/purposes The aim of this study was to analyze changes or differences in the trabecular microarchitecture of the talus with regard to (1) age and (2) sex. Methods Sixty human tali were harvested from 30 patients at autopsy of three different age groups (20-40, 41-60, 61-80 years). The specimens were analyzed by radiography, micro-CT, and histological analysis. Given that there was no difference between the left and right talus, static histomorphometric parameters were assessed in three regions of interest of the right talus only (body, neck, head; n = 30). Results The talar body, neck, and head were affected differently by age-related changes. The greatest loss of bone volume with age was seen in the talar body (estimate: À0.239; 95% confidence interval [CI], À0.365 to À0.114; p \ 0.001). In the talar neck (estimate: À0.165; 95% CI, À0.307 to À0.023; p = 0.025), bone loss was only moderate and primarily was the result of reduction in trabecular thickness (estimate: À1.288; 95% CI, À2.449 to À0.127; p = 0.031) instead of number (estimate: À0.001; 95% CI, À0.005 to À0.003; p = 0.593). Bone structure changes were independent of sex. Conclusions Age-related bone structure changes predominantly occur in the talar body, which poses a potential risk factor for total ankle replacement loosening. The moderate changes in the talar neck might explain the persistent low incidence of talar neck fractures with age.

show abstract

Section: Discussionmentioning

confidence: 98%

Bone Microarchitecture of the Talus Changes With Aging

Krause

Rupprecht

Mumme

et al. 2013

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

show abstract

“…Image analysis has been described and validated (17, 24, 25, 37). Briefly, the entire volume of interest is automatically separated into cortical and trabecular regions by using a threshold-based algorithm.…”

Section: Methodsmentioning

confidence: 99%

“…Moreover, HRpQCT has been developed to visualize the microstructure of the distal radius, an unloaded site, and the distal tibia, a loaded site. Strong correlations between microarchitecture assessed by HRpQCT and histomorphometry or µCT at the same bony regions have been demonstrated (17, 18). This technology further distinguishes subjects who have sustained vertebral and non-vertebral fractures from normal controls (19–23), and detects changes in bone microstructure related to aging or other causes of bone loss (24–26).…”

Section: Introductionmentioning

confidence: 99%

Primary hyperparathyroidism is associated with abnormal cortical and trabecular microstructure and reduced bone stiffness in postmenopausal women

Stein

Silva

Boutroy

et al. 2012

Journal of Bone and Mineral Research

184

103

View full text Add to dashboard Cite

Typically, in the milder form of primary hyperparathyroidism (PHPT), seen in most countries now, bone density by DXA and detailed analyses of iliac crest bone biopsies by histomorphometry and µCT show detrimental effects in cortical bone, whereas the trabecular site (lumbar spine by DXA) and the trabecular compartment (by bone biopsy) appear to be relatively well preserved. Despite these findings, fracture risk at both vertebral and non-vertebral sites is increased in PHPT. Emerging technologies, such as high-resolution peripheral quantitative computed tomography (HRpQCT), may provide additional insight into microstructural features at sites such as the forearm and tibia that have heretofore not been easily accessible. Using HRpQCT, we determined cortical and trabecular microstructure at the radius and tibia in 51 postmenopausal women with PHPT and 120 controls. Individual trabecula segmentation (ITS) and micro finite element (µFE) analyses of the HRpQCT images were also performed to further understand how the abnormalities seen by HRpQCT might translate into effects on bone strength. Women with PHPT showed, at both sites, decreased volumetric densities at trabecular and cortical compartments, thinner cortices, and more widely spaced and heterogeneously distributed trabeculae. At the radius, trabeculae were thinner and fewer in PHPT. The radius was affected to a greater extent in the trabecular compartment than the tibia. ITS analyses revealed, at both sites, that plate-like trabeculae were depleted, with a resultant reduction in the plate/rod ratio. Microarchitectural abnormalities were evident by decreased plate-rod and plate-plate junctions at the radius and tibia, and rod-rod junctions at the radius. These trabecular and cortical abnormalities resulted in decreased whole bone stiffness and trabecular stiffness. These results provide evidence that in PHPT, microstructural abnormalities are pervasive and not limited to the cortical compartment. They may help to account for increased global fracture risk in PHPT.

show abstract

“…In the present study, we did not see a decrease in cortical porosity, which is in contrast to the transient observation at year 2 in the earlier study of the same biopsy samples from the FREEDOM study and in proximal femur analyzed by QCT . The measurement of Ct.Po may have been influenced by the methods using 2D or 3D imaging with different resolutions . Histomorphometry allows the detection of small pores with a diameter of about 5 μm when the pores detected by μCT depend on the resolution used, which was 27 μm in the earlier assessment .…”

Section: Discussionmentioning

confidence: 96%

Reduction of Cortical Bone Turnover and Erosion Depth After 2 and 3 Years of Denosumab: Iliac Bone Histomorphometry in the FREEDOM Trial

Chavassieux

Portero-Muzy

Roux

et al. 2019

Journal of Bone and Mineral Research

Self Cite

View full text Add to dashboard Cite

Denosumab, a RANKL inhibitor, reduced the risk of vertebral, hip, and nonvertebral fractures in the Fracture REduction Evaluation of Denosumab in Osteoporosis every 6 Months (FREEDOM) trial of postmenopausal women with osteoporosis compared with placebo. Previous bone histomorphometric analysis in FREEDOM showed decreased bone resorption and turnover in cancellous bone after 2 and 3 years. The purpose of the present study was to evaluate the effects of denosumab compared with placebo in the cortical compartment from transiliac bone biopsies obtained during FREEDOM. A total of 112 specimens were evaluable for cortical histomorphometry, including 67 obtained at month 24 (37 placebo, 30 denosumab) and 45 at month 36 (25 placebo, 20 denosumab). Eroded surface, osteoclast surface, erosion depth, and wall thickness were measured on the endocortical surface. Cortical thickness and cortical porosity were also measured. Dynamic parameters of bone formation were assessed for endocortical, periosteal, and intracortical envelopes. Endocortical osteoclast surface, eroded surface, and mean and maximum erosion depth were significantly lower in the denosumab group versus placebo at months 24 and 36 (p < 0.0001 to p = 0.04). Endocortical wall thickness and intracortical measures (cortical porosity and cortical thickness) were not different between the two groups. Dynamic parameters were low with tetracycline labels in cortical bone observed in 13 (43%) and 10 (50%) of denosumab biopsies at months 24 and 36, respectively, reflecting a marked decrease in bone turnover. In conclusion, our data reveal the mechanism of action of denosumab on cortical bone: inhibition of osteoclastic resorption and reduced activation of new remodeling sites. In addition, reduced endocortical erosion depth with no change of wall thickness may contribute to increased bone strength by reducing the bone loss and fragility associated with deep resorption cavities and may likely contribute to the greater BMD gain with denosumab than with other antiresorptive agents. © 2018 The Authors. Journal of Bone and Mineral Research Published by Wiley Periodicals Inc.

show abstract

Comparison of 2D and 3D bone microarchitecture evaluation at the femoral neck, among postmenopausal women with hip fracture or hip osteoarthritis

Cited by 35 publications

References 39 publications

Bone Microarchitecture of the Talus Changes With Aging

Bone Microarchitecture of the Talus Changes With Aging

Primary hyperparathyroidism is associated with abnormal cortical and trabecular microstructure and reduced bone stiffness in postmenopausal women

Reduction of Cortical Bone Turnover and Erosion Depth After 2 and 3 Years of Denosumab: Iliac Bone Histomorphometry in the FREEDOM Trial

Contact Info

Product

Resources

About