Osteopenia, hematopoiesis, and bone remodelling in iliac crest and femoral biopsies: A prospective study of 102 cases of femoral neck fractures

Eventov, I.; Frisch, Bertha; Hammel, Ilan

doi:10.1016/8756-3282(91)90047-m

Cited by 85 publications

(26 citation statements)

References 29 publications

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“…Fourth, the age range of the subjects was limited so that any effects of age in this small data set on cortical and cancellous bone parameters could not be identified. Last, although previous studies have noted that osteopenia of the cancellous bone may be a contributory factor to fracture risk, (10,15) this was not apparent in our study. This is not surprising since Eventov et al (10) commented that a third of the femoral necks examined had no evidence of osteopenia and our sample size was relatively small.…”

Section: Discussioncontrasting

confidence: 55%

“…Although it is well documented that bone loss occurs in the femoral neck, (8)(9)(10)(11)(12)(13)(14)(15)(16) it was not clear whether this is due to generalized bone loss affecting cortical and cancellous bone equally or due to more localized reductions in bone mass. By dividing the femoral neck cross-section into eight regions (as used by Crofts et al (19) and previously by Jowsey et al (20) ) we were able to identify specific areas where cortical bone was deficient in comparison with controls.…”

Section: Discussionmentioning

confidence: 99%

“…(8)(9)(10)(11)(12)(13)(14)(15)(16) From these studies, it is apparent that there are changes in the structural features of the femoral neck associated with aging and fracture. Eventov et al (10) have demonstrated osteopenia in the trabecular microanatomy of femoral neck biopsies taken superiorly. Cortical remodeling changes re-sulting in a reduction in the amount of cortical bone and increased porosity due to expansion of the Haversian canal area have also been identified.…”

mentioning

confidence: 99%

“…(7) Despite the pathological importance of femoral neck fracture only a few investigators have examined the bone structure and histology of the femoral neck. (8)(9)(10)(11)(12)(13)(14)(15)(16) From these studies, it is apparent that there are changes in the structural features of the femoral neck associated with aging and fracture. Eventov et al (10) have demonstrated osteopenia in the trabecular microanatomy of femoral neck biopsies taken superiorly.…”

mentioning

confidence: 99%

“…Some of the studies have only examined fracture cases (8) or femoral necks from autopsy samples. (14) Other studies have compared fractures with osteoarthritic cases (15) instead of age-matched cadaveric material, femoral neck parameters to those of the iliac crest, (9,10) or have only studied a selected region of the femoral neck. (11,12) In a previous study, an image analysis system to assess the proportions and distribution of cortical and cancellous bone in the femoral neck was evaluated.…”

mentioning

confidence: 99%

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Structure of the Femoral Neck in Hip Fracture: Cortical Bone Loss in the Inferoanterior to Superoposterior Axis

Bell

Loveridge

Power

et al. 1999

Journal of Bone and Mineral Research

192

166

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Although bone mass is a contributory risk factor for hip fracture, its distribution about the femoral neck is also important. Femoral neck biopsies were obtained from 13 females with intracapsular hip fracture (fracture: mean age 74.3 ± 2.3 years [SEM]) and 19 cadaveric samples (control: 9 males and 10 females 79.4 ± 1.7 years) and the areas of cortical and cancellous bone were quantitated in octants. In the control group, although males had larger bones than females, the proportions of cortical and cancellous bone were not different (p > 0.05) between the genders. The total amount of bone, as a proportion of bone + marrow, was significantly reduced in the fractures compared with the female controls (%Tt.Ar: fracture 27.83 ± 1.18, female control 33.62 ± 1.47; p = 0.0054). Reductions in cortical bone area occurred in all regions but particularly in the inferior, inferoanterior, and anterior octants (p < 0.05). There were no differences between cases and controls in the regional amount of cancellous bone (all regions, p > 0.178). Marked reductions in mean cortical bone width between the fracture and female control group occurred in the anterior, inferoanterior (31%), and superoposterior (25%) regions. Representing cortical widths as simple Fourier functions of the angle about the center of area (R 2 adj = 0.79) showed in the cases that there was preservation of the cortical bone in the inferior region, with the proportional loss of cortical bone being greatest in the inferoanterior and superoposterior regions. It is concluded that loss of cortical, rather than cancellous, bone predominates in cases of femoral neck fracture. This loss occurs primarily along the inferoanterior to superoposterior axis. As this axis bears the greatest strain during a fall, it is hypothesized that specific thinning of the cortex in these regions leads to an exaggerated propensity to fracture in those so affected, above that resulting from an equivalent general decrease in bone mass. (J Bone Miner Res 1999;14:111-119)

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Section: Discussioncontrasting

confidence: 55%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Structure of the Femoral Neck in Hip Fracture: Cortical Bone Loss in the Inferoanterior to Superoposterior Axis

Bell

Loveridge

Power

et al. 1999

Journal of Bone and Mineral Research

192

166

View full text Add to dashboard Cite

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Bone resorption at the femoral neck is dependent on local factors in nonosteoporotic late postmenopausal women: An in vitro-in vivo study

Cohen‐Solal

Graulet

Guéris

et al. 1995

Journal of Bone and Mineral Research

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Local mediators of bone resorption may be involved in bone loss in recently postmenopausal women and in osteoporosis. In the present study, we investigated the production of cytokines and the formation of osteoclast-like cells in marrow cultures from 16 late postmenopausal nonosteoporotic women (mean age: 66 +/- 8 years; time after menopause: 15 +/- 8 years) undergoing hip replacement for arthrosis. Marrow adherent mononuclear cells (MMNC) isolated from femoral diaphysis marrow were cultured for 10 days in the absence or in the presence of 1,25(OH)2D3. In vivo bone resorption was concomitantly assessed by histomorphometry on femoral neck bone sections. The number of TRAP+ multinucleated cells obtained after 10 days in MMNC cultured in the presence of 1,25(OH)2D3 correlated with the number of osteoclasts measured on the bone femoral neck biopsies (r = 0.65, p < 0.01), suggesting that the formation of multinucleated cells in vitro could reflect the osteoclast differentiation in vivo. Furthermore, the number of osteoclasts was related to the eroded volume and the trabecular separation of the femoral neck bone biopsies. Finally, the release of interleukin-1 (IL-1), IL-6, and TNF-alpha by cultures of peripheral blood mononuclear cells (PBMC) and MMNC was measured by radioimmunoassay. The cytokine levels of basal and 1,25(OH)2D3-treated MMNC decreased from days 2 to 5 and then reached a plateau to day 10. The number of TRAP+ multinucleated cells obtained after 10 days in MMNC cultures correlated with the basal IL-6 release in the same cultures determined at day 2 (r = 0.55, p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

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Fluoride and the FDA: A curious case

Turner

1996

Journal of Bone and Mineral Research

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Osteopenia, hematopoiesis, and bone remodelling in iliac crest and femoral biopsies: A prospective study of 102 cases of femoral neck fractures

Cited by 85 publications

References 29 publications

Structure of the Femoral Neck in Hip Fracture: Cortical Bone Loss in the Inferoanterior to Superoposterior Axis

Structure of the Femoral Neck in Hip Fracture: Cortical Bone Loss in the Inferoanterior to Superoposterior Axis

Bone resorption at the femoral neck is dependent on local factors in nonosteoporotic late postmenopausal women: An in vitro-in vivo study

Fluoride and the FDA: A curious case

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