Bone microstructure in the different regions and stages of human osteonecrotic femoral heads

Cheng Wang, Xin Wang, Xiao-long Xu, Xue-ling Yuan, Wen-long Gou, Ai-yuan Wang, Quan-yi Guo, Jiang Peng, Shi-bi Lu
2014 Journal of Orthopaedic Translation  
KOA patients was significantly higher than early stage of KOA patients (early stage group 96.4 AE 27.1pg/ml, middle stage group 153.3 AE 16.9pg/ml, advanced stage group 149.5 AE 36.7pg/ml). NPY of advanced stage of KOA patients has no significant difference compare with middle stage of KOA patients. These results contradict the notion that NPY has significant relevance to joint pain in patients with KOA. It means a lack of agreement between X-rays evidence of KOA and patients' report of pain at
more » ... ' report of pain at that site based on the result of our studies, which are the first study specifically designed to evaluate the relationship between NPY and KOA pain. Conclusion: This study demonstrated the presence and variation of NPY in the KOA joint fluid, suggesting a role for NPY as a putative regulator of pain transmission and perception in KOA pain. Objective: To detect and compare the bone microstructure in different regions and stages of human osteonecrotic femoral heads. Methods: Thirteen osteonecrotic femoral heads (3 FicatⅡand 10 Ficat IV) were obtained from patients undergoing total hip arthroplasty. The samples were divided into subchondral bone, necrotic, sclerotic, and healthy regions based on micro-computed tomography (micro-CT) images. The bone microstructure was assessed using micro-CT and pathology. Results: (1) The spatial structure of the bone trabeculae differed markedly in the various regions of the osteonecrotic femoral heads. (2) In Ficat Ⅱ group, the subchondral bone and sclerosis region had higher BMD, BV/TV and lower Tb.Sp compare to healthy region, And the collapsed region had higher Tb.Sp and lower Tb.N. (3) In Ficat IV group, the sclerosis regions had higher BMD, BV/TV and lower Tb.Sp compare to healthy region. And the collapsed and subchondral bone region had higher Tb.Sp and lower BV/TV, BMD and Tb.N. Conclusion: (1) The different regions in osteonecrosis femoral head have a different spatial structure and pathological feature. (2) Micro fracture and bone resorption had already appeared since the early stage. It is not certain that only mechanical support can prevent the collapse of osteonecrotic femoral heads.
doi:10.1016/j.jot.2014.07.081 fatcat:2fbybmarqff5hc3334un5tuiqq