Femoral Expansion in Aging Women: Implications for Osteoporosis and Fractures

Smith, Richmond W.; Walker, Richard R.

doi:10.1126/science.145.3628.156

Cited by 294 publications

(144 citation statements)

References 3 publications

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“…Periosteal expansion occurs throughout life. The rate of expansion is high during puberty, 17 slower during the adult years 106,117 and in women, accelerated again after menopause. 1 Independently of other changes, expansion of the periosteal surface increases the strength of long bones and decreases the risk of fracture.…”

Section: Microscopic Featuresmentioning

confidence: 98%

“…These cells likely do serve to expand the periosteal diameter, as the femoral neck experiences age-associated radial expansion. 11,106,117 It may be, however, that limited quantity of cells limits the rate of expansion, resulting in less than optimal bone geometry and therefore elevated fracture risk. Alternatively, these data may present supporting evidence that the femoral neck exhibits an alternative means of periosteal apposition.…”

Section: Microscopic Featuresmentioning

confidence: 99%

See 1 more Smart Citation

RETRACTED: The periosteum

Augustin¹,

Antabak²,

Davila³

2007

Injury

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Section: Microscopic Featuresmentioning

confidence: 98%

Section: Microscopic Featuresmentioning

confidence: 99%

RETRACTED: The periosteum

Augustin¹,

Antabak²,

Davila³

2007

Injury

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“…The present study, with a larger sample of femoral necks, is consistent with their findings. The periosteum plays a vital role in bone formation and radial bone expansion with age (Smith & Walker, 1964). A recent investigation by Benjamin et al (2000) observed ossification of the calcified fibrocartilage zone of the Achilles tendon in young rats.…”

Section: mentioning

confidence: 99%

Evidence of a hypermineralised calcified fibrocartilage on the human femoral neck and lesser trochanter

Shea¹,

Vajda

Bloebaum³

2001

Journal of Anatomy

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Femoral neck fractures are a major cause of morbidity and mortality in elderly humans. In addition to the age-related loss of cancellous bone, changes to the microstructure and morphology of the metaphyseal cortex may be a contributing factor in osteoporotic hip fractures. Recent investigations have identified a hypermineralised tissue on the neck of the femur and trochanteric region that increases in fractional area with advancing age in both males (Boyce & Bloebaum, 1993) and females (Vajda & Bloebaum, 1999). The aim of this study was to determine if the hypermineralised tissue previously observed on the proximal femur is calcified fibrocartilage. Regional variations in the fractional area of hypermineralised tissue, cortical bone, and porosity of the cortical bone along the neck of the femur and lesser trochanter were also quantified. Comparison of back scattered electron and light microscope images of the same area show that regions of hypermineralised tissue correlate with the regions of calcified fibrocartilage from tendon and capsular insertions. The hypermineralised tissue and calcified fibrocartilage had similar morphological features such as the interdigitations of the calcified fibrocartilage into the bone, lacunar spaces, and distinctly shaped pores adjacent to the 2 tissues. Regions of the neck that did not contain insertions were covered with periosteum. There were no regional differences (P 0n05) on the superior and inferior femoral neck in terms of the percentage area of hypermineralised calcified fibrocartilage, cortical bone, or cortical bone porosity. The lesser trochanter exhibited regional differences in the fractional area of hypermineralised calcified fibrocartilage (P l 0n007) and cortical bone (P l 0n007) but not porosity of the cortical bone (P 0n05). The effects of calcified fibrocartilage on femoral neck periosteal expansion, repair, and mechanics are unknown, but may play a role in osteoporotic fractures and intracapsular fracture healing.

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“…Various reports have supported the role of periosteal apposition as a mechanism to preserve bone strength in the context of agerelated trabecular and cortical bone loss [1,3,7,9,12,19,30,31,33,36,37]. However, none of these reports have focused on examining age-related material and geometric changes in the trochanter and comparing these changes to those observed in the femoral neck.…”

Section: Introductionmentioning

confidence: 99%

Young-elderly differences in bone density, geometry and strength indices depend on proximal femur sub-region: A cross sectional study in Caucasian-American women

Meta

Lü

Keyak

et al. 2006

Bone

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Fragility fractures at the trochanter (TR) and the femoral neck (FN) have distinct etiologies, but the underlying age-related structural changes at these proximal femoral sub-regions are poorly understood. 28 young (41 ± 3 years) and 124 elderly (74 ± 3 years) healthy Caucasian women underwent volumetric quantitative computed tomography at the hip. Integral (i), cortical (c) and trabecular (t) bone mineral density and content (BMD, BMC) were measured. Geometric parameters included cross sectional area (CSA), and volumes of the integral, cortical and trabecular regions (VOL). Structural measures included indices of compressive (Compstr) and bending (BSI) strength. After adjusting for height and weight, an F-test was used to compare the TR and the FN mean values between young and elderly and to test for interaction to compare logarithmic difference of young and elderly (log(Young)-log(Elderly), Y/E d ) between the FN and the TR in an ANOCOVA model. All BMC, iBMD and tBMD values were significantly lower in elderly than in young women, with the largest Y/E d in the FN tBMC and tBMD (P < 0.0011 and P < 0.0001). cBMD in young and elderly groups was not significantly different at the TR while at the FN it was greater (P = 0.0075) in elderly than young women, showing significant Y/E d (P = 0.0003) dependence on skeletal site. Elderly women had significantly larger iVOL and CSA values (0.0001 < P < 0.0051), except for the FN iVOL. cVOL values were smaller in elderly than young women (P < 0.0001). Y/E d in bone geometry differed by sub-region only for cVOL measures (P = 0.0267). Despite larger CSA and iVOL measures in elderly, the younger women had greater Compstr (P < 0.0001) and BSI (P = 0.0051). Thus, although both the TR and the FN appear to increase in size with age, this enlargement is insufficient to protect against loss of bone strength.

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Femoral Expansion in Aging Women: Implications for Osteoporosis and Fractures

Cited by 294 publications

References 3 publications

RETRACTED: The periosteum

RETRACTED: The periosteum

Evidence of a hypermineralised calcified fibrocartilage on the human femoral neck and lesser trochanter

Young-elderly differences in bone density, geometry and strength indices depend on proximal femur sub-region: A cross sectional study in Caucasian-American women

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