Lower limb bone geometry in adult individuals with X-linked hypophosphatemia: an observational study.


Journal

Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA
ISSN: 1433-2965
Titre abrégé: Osteoporos Int
Pays: England
ID NLM: 9100105

Informations de publication

Date de publication:
Jul 2022
Historique:
received: 07 12 2021
accepted: 25 03 2022
pubmed: 19 4 2022
medline: 15 6 2022
entrez: 18 4 2022
Statut: ppublish

Résumé

We assessed lower-limb geometry in adults with X-linked hypophosphatemia (XLH) and controls. We found large differences in multiple measures including femoral and tibial torsion, bowing and cross-sectional area and acetabular version and coverage which may contribute to clinical problems such as osteoarthritis, fractures and altered gait common in XLH. Individuals with X-linked hypophosphatemia (XLH) are at risk of lower-limb deformities and early onset of osteoarthritis. These two factors may be linked, as altered biomechanics is a risk factor for osteoarthritis. This exploratory evaluation aims at providing clues and concepts for this association to facilitate future larger-scale and longitudinal studies on that aspect. For this observational study, 13 patients with XLH, aged 18-65 years (6 female), were compared with sex-, age- and weight-matched healthy individuals at a single German research centre. Femoral and hip joint geometry, including femoral and tibial torsion and femoral and tibial shaft bowing, bone cross-sectional area (CSA) and acetabular version and coverage were measured from magnetic resonance imaging (MRI) scans. Total femoral torsion was 29° lower in individuals with XLH than in controls (p < 0.001), mainly resulting from lower intertrochanteric torsion (ITT) (p < 0.001). Femoral lateral and frontal bowing, tibial frontal bowing, mechanical axis, femoral mechanical-anatomical angle, acetabular version and acetabular coverage were all greater and tibial torsion lower in individuals with XLH as compared to controls (all p < 0.05). Greater femoral total and marrow cavity CSA, greater tibial marrow cavity CSA and lower cortical CSA were observed in XLH (all p < 0.05). We observed large differences in clinically relevant measures of tibia and particularly femur bone geometry in individuals with XLH compared to controls. These differences may plausibly contribute to clinical manifestations of XLH such as early-onset osteoarthritis, pseudofractures and altered gait and therefore should be considered when planning corrective surgeries.

Identifiants

pubmed: 35435480
doi: 10.1007/s00198-022-06385-z
pii: 10.1007/s00198-022-06385-z
pmc: PMC9187561
doi:

Types de publication

Journal Article Observational Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

1601-1611

Informations de copyright

© 2022. The Author(s).

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Auteurs

Matteo Scorcelletti (M)

Research Centre for Musculoskeletal Science and Sports Medicine, Department of Life Sciences, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, UK.

Serhan Kara (S)

Division of Muscle and Bone Metabolism, Institute of Aerospace Medicine DLR, Cologne, Germany.

Jochen Zange (J)

Division of Muscle and Bone Metabolism, Institute of Aerospace Medicine DLR, Cologne, Germany.

Jens Jordan (J)

Division of Muscle and Bone Metabolism, Institute of Aerospace Medicine DLR, Cologne, Germany.

Oliver Semler (O)

Department of Pediatrics and Adolescent Medicine, University of Cologne, Cologne, Germany.

Eckhard Schönau (E)

Department of Pediatrics and Adolescent Medicine, University of Cologne, Cologne, Germany.

Jörn Rittweger (J)

Division of Muscle and Bone Metabolism, Institute of Aerospace Medicine DLR, Cologne, Germany.
Department of Pediatrics and Adolescent Medicine, University of Cologne, Cologne, Germany.

Alex Ireland (A)

Research Centre for Musculoskeletal Science and Sports Medicine, Department of Life Sciences, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, UK.

Lothar Seefried (L)

Orthopaedic Department, University of Würzburg, Wurzburg, Germany. l-seefried.klh@uni-wuerzburg.de.

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