Atraumatic femoral head necrosis: a biomechanical, histological and radiological examination compared to primary hip osteoarthritis.
Biomechanical evaluation
Femoral head necrosis
Histological evaluation
Primary hip osteoarthritis
Thin-slice CT
Journal
Archives of orthopaedic and trauma surgery
ISSN: 1434-3916
Titre abrégé: Arch Orthop Trauma Surg
Pays: Germany
ID NLM: 9011043
Informations de publication
Date de publication:
Nov 2022
Nov 2022
Historique:
received:
10
09
2020
accepted:
31
03
2021
pubmed:
11
5
2021
medline:
4
10
2022
entrez:
10
5
2021
Statut:
ppublish
Résumé
Atraumatic necrosis of the femoral head (AFHN) is a common disease with an incidence of 5000-7000 middle-aged adults in Germany. There is no uniform consensus in the literature regarding the configuration of the bone in AFHN. The clinical picture of our patients varies from very hard bone, especially in idiopathic findings, and rather soft bone in cortisone-induced necrosis. A better understanding of the underlying process could be decisive for establishing a morphology-dependent approach. The aim of this study is the closer examination of the condition of the bone in the AFHN compared to the primary hip osteo arthritis (PHOA). The preparations were obtained as part of elective endoprosthetic treatment of the hip joint. Immediately after sample collection, thin-slice CT of the preserved femoral heads was performed to determine the exact density of the bone in the necrosis zone. Reconstruction was done in 0.8-1 mm layers in two directions, coronary and axial, starting from the femoral neck axis. Density of the femoral heads was determined by grey value analysis. The value in Hounsfield units per sample head was averaged from three individual measurements to minimize fluctuations. For biomechanical and histomorphological evaluation, the samples were extracted in the load bearing zone perpendicular to the surface of the femoral head. Group-dependent statistical evaluation was performed using single factor variance analysis (ANOVA). A total of 41 patients with a mean age of 64.44 years were included. The mean bone density of the AFHN samples, at 1.432 g/cm The present study (NCT, evidence level II) shows that AFHN has a very well detectable higher bone density compared to PHOA. However, neither biomechanical stress tests nor histomorphological evaluation did show any significant difference between the groups. The results allow the conclusion that there is no "soft" necrosis at all in the AFHN group.
Identifiants
pubmed: 33970320
doi: 10.1007/s00402-021-03890-4
pii: 10.1007/s00402-021-03890-4
pmc: PMC9522715
doi:
Substances chimiques
Cortisone
V27W9254FZ
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
3093-3099Commentaires et corrections
Type : ErratumIn
Informations de copyright
© 2021. The Author(s).
Références
Calcif Tissue Int. 2002 Sep;71(3):227-34
pubmed: 12170373
Stain Technol. 1954 Sep;29(5):225-39
pubmed: 13195889
Rev Prat. 1979 Jan 21;29(5):479-89
pubmed: 482822
Hip. 1983;:249-62
pubmed: 6671914
Clin Orthop Relat Res. 1981 May;(156):240-7
pubmed: 7226659
Osteoarthritis Cartilage. 1993 Oct;1(4):219-32
pubmed: 15449509
Orthopedics. 1991 Oct;14(10):1111-6
pubmed: 1946047
Clin Biomech (Bristol, Avon). 2021 Feb;82:105280
pubmed: 33582564
Can J Surg. 1981 Nov;24(6):573-8
pubmed: 7326618
Acta Orthop Scand. 1989 Aug;60(4):415-7
pubmed: 2816318
Skeletal Radiol. 1992;21(4):229-38
pubmed: 1626289
Arch Orthop Trauma Surg. 2016 Feb;136(2):165-74
pubmed: 26667621
J Biomech. 2010 Apr 19;43(6):1160-6
pubmed: 20056226
Am J Pathol. 1938 Mar;14(2):237-43
pubmed: 19970387
Dtsch Arztebl Int. 2016 Jan 22;113(3):31-8
pubmed: 26857510