Sex-Specific Association of Clinical Parameters and Components of Femoral Bone Quality in Patients Undergoing Total Hip Arthroplasty.
DXA
Osteoarthritis
Osteocytes
Osteoporosis
THA
Journal
Calcified tissue international
ISSN: 1432-0827
Titre abrégé: Calcif Tissue Int
Pays: United States
ID NLM: 7905481
Informations de publication
Date de publication:
14 Sep 2024
14 Sep 2024
Historique:
received:
23
05
2024
accepted:
28
08
2024
medline:
15
9
2024
pubmed:
15
9
2024
entrez:
14
9
2024
Statut:
aheadofprint
Résumé
Poor bone quality is a critical factor associated with an increased risk of complications after total hip arthroplasty (THA). However, no consistent recommendations have yet been established for assessing indicators of bone quality preoperatively. Thus, it remains unclear which preoperatively available and readily accessible parameters are most closely associated with femoral bone quality. Here, we obtained femoral neck specimens from 50 patients undergoing THA. Preoperative Dual-energy X-ray absorptiometry (DXA) scans, pelvic radiographs, and laboratory parameters were analyzed. In the obtained specimens, bone microstructure was assessed using micro-CT and histomorphometry. Additionally, matrix mineralization and osteocyte lacunar morphology were evaluated using quantitative backscattered electron imaging. Our analysis revealed that DXA-derived T-scores correlated with trabecular microstructure. Furthermore, radiographic indices and body mass index correlated differentially with aspects of bone quality in women and men. Contrary to previous observations, no correlation was found between serum vitamin D levels and osteoid indices, nor between clinical parameters and matrix mineralization. Age was strongly associated with the number of mineralized osteocyte lacunae, a factor that appeared to be independent of sex. Taken together, our study demonstrates that no single preoperatively available parameter exhibits a strong and consistent association with femoral bone quality. However, DXA remains a reliable preoperative measure for determining the trabecular microstructure of the femoral neck. In clinical practice, surgeons should adopt an individualized approach to preoperative assessments by considering age, sex, BMI, and radiographic indices to enhance their insight into femoral bone quality, particularly when DXA is unavailable.
Identifiants
pubmed: 39277556
doi: 10.1007/s00223-024-01286-1
pii: 10.1007/s00223-024-01286-1
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024. The Author(s).
Références
Burge R, Dawson-Hughes B, Solomon DH, Wong JB, King A, Tosteson A (2007) Incidence and economic burden of osteoporosis-related fractures in the United States, 2005–2025. J Bone Miner Res 22:465–475
doi: 10.1359/jbmr.061113
pubmed: 17144789
Long H, Liu Q, Yin H, Wang K, Diao N, Zhang Y, Lin J, Guo A (2022) Prevalence trends of site-specific osteoarthritis from 1990 to 2019: findings from the global burden of disease study 2019. Arthritis Rheumatol 74:1172–1183
doi: 10.1002/art.42089
pubmed: 35233975
pmcid: 9543105
Clynes MA, Harvey NC, Curtis EM, Fuggle NR, Dennison EM, Cooper C (2020) The epidemiology of osteoporosis. Br Med Bull 133:105–117
pubmed: 32282039
Parkkari J, Kannus P, Palvanen M, Natri A, Vainio J, Aho H, Vuori I, Järvinen M (1999) Majority of hip fractures occur as a result of a fall and impact on the greater trochanter of the femur: a prospective controlled hip fracture study with 206 consecutive patients. Calcif Tissue Int 65:183–187
doi: 10.1007/s002239900679
pubmed: 10441647
Veronese N, Maggi S (2018) Epidemiology and social costs of hip fracture. Injury 49:1458–1460
doi: 10.1016/j.injury.2018.04.015
pubmed: 29699731
Salaffi F, Carotti M, Grassi W (2005) Health-related quality of life in patients with hip or knee osteoarthritis: comparison of generic and disease-specific instruments. Clin Rheumatol 24:29–37
doi: 10.1007/s10067-004-0965-9
pubmed: 15674656
Ferguson RJ, Palmer AJ, Taylor A, Porter ML, Malchau H, Glyn-Jones S (2018) Hip replacement. Lancet 392:1662–1671
doi: 10.1016/S0140-6736(18)31777-X
pubmed: 30496081
Knight SR, Aujla R, Biswas SP (2011) Total hip arthroplasty—over 100 years of operative history. Orthop Rev (Pavia) 3:e16
pubmed: 22355482
Russell LA (2013) Osteoporosis and orthopedic surgery: effect of bone health on total joint arthroplasty outcome. Curr Rheumatol Rep 15:371
doi: 10.1007/s11926-013-0371-x
pubmed: 24085661
Wilkinson JM, Hamer AJ, Rogers A, Stockley I, Eastell R (2003) Bone mineral density and biochemical markers of bone turnover in aseptic loosening after total hip arthroplasty. J Orthop Res 21:691–696
doi: 10.1016/S0736-0266(02)00237-1
pubmed: 12798070
Aro HT, Alm JJ, Moritz N, Mäkinen TJ, Lankinen P (2012) Low BMD affects initial stability and delays stem osseointegration in cementless total hip arthroplasty in women: a 2-year RSA study of 39 patients. Acta Orthop 83:107–114
doi: 10.3109/17453674.2012.678798
pubmed: 22489886
pmcid: 3339522
Whiting PS, Hare K, Krueger D, Borchardt G, Parvanta-Johnson K, Bernatz J, Binkley N, Anderson PA (2024) Periprosthetic fractures are osteoporotic fractures: missed opportunities for osteoporosis diagnosis. Osteoporos Int 35:1165–1171
doi: 10.1007/s00198-024-07057-w
pubmed: 38561550
Delsmann MM, Strahl A, Muhlenfeld M, Jandl NM, Beil FT, Ries C, Rolvien T (2021) High prevalence and undertreatment of osteoporosis in elderly patients undergoing total hip arthroplasty. Osteoporos Int 32:1661–1668
doi: 10.1007/s00198-021-05881-y
pubmed: 33575911
pmcid: 8376703
Matsubara M, Morita S, Shinomiya K, Kawamata R, Nakamura K, Kashima I (2003) Structuring parameters for assessment of bone quality using a morphological filter and star volume analysis: structuring property in the cancellous bone of the human femoral head. J Bone Miner Metab 21:48–56
doi: 10.1007/s007740300008
pubmed: 12491094
Liu Y, Ma WJ, Huang K, Yang J, Zeng Y, Shen B (2022) Radiographic indexes in AP hip radiographs prior to total hip arthroplasty reveal candidates with low BMD. Osteoporos Int 33:871–879
doi: 10.1007/s00198-021-06231-8
pubmed: 34775528
Noble PC, Box GG, Kamaric E, Fink MJ, Alexander JW, Tullos HS (1995) The effect of aging on the shape of the proximal femur. Clin Orthop Relat Res 316:31–44
doi: 10.1097/00003086-199507000-00006
von Kroge S, Buyukyilmaz Z, Alimy AR, Hubert J, Citak M, Amling M, Beil FT, Ohlmeier M, Rolvien T (2023) Do clinical parameters reflect local bone metabolism in heterotopic ossification after septic or aseptic THA? Clin Orthop Relat Res 481:2029–2041
doi: 10.1097/CORR.0000000000002758
von Kroge S, Sturznickel J, Bechler U, Stockhausen KE, Eissele J, Hubert J, Amling M, Beil FT, Busse B, Rolvien T (2022) Impaired bone quality in the superolateral femoral neck occurs independent of hip geometry and bone mineral density. Acta Biomater 141:233–243
doi: 10.1016/j.actbio.2022.01.002
Dempster DW, Compston JE, Drezner MK, Glorieux FH, Kanis JA, Malluche H, Meunier PJ, Ott SM, Recker RR, Parfitt AM (2013) Standardized nomenclature, symbols, and units for bone histomorphometry: a 2012 update of the report of the ASBMR Histomorphometry Nomenclature Committee. J Bone Miner Res 28:2–17
doi: 10.1002/jbmr.1805
pubmed: 23197339
Danyukova T, Alimy AR, Velho RV, Yorgan TA, Di Lorenzo G, von Kroge S, Tidow H, Wiegert JS, Hermans-Borgmeyer I, Schinke T, Rolvien T, Pohl S (2023) Mice heterozygous for an osteogenesis imperfecta-linked MBTPS2 variant display a compromised subchondral osteocyte lacunocanalicular network associated with abnormal articular cartilage. Bone 177:116927
doi: 10.1016/j.bone.2023.116927
pubmed: 37797712
Rolvien T, Krause M, Jeschke A, Yorgan T, Püschel K, Schinke T, Busse B, Demay MB, Amling M (2017) Vitamin D regulates osteocyte survival and perilacunar remodeling in human and murine bone. Bone 103:78–87
doi: 10.1016/j.bone.2017.06.022
pubmed: 28666969
Delsmann J, Eissele J, Simon A, Alimy AR, von Kroge S, Mushumba H, Puschel K, Busse B, Ries C, Amling M, Beil FT, Rolvien T (2024) Alterations in compositional and cellular properties of the subchondral bone are linked to cartilage degeneration in hip osteoarthritis. Osteoarthritis Cartilage 32:535–547
doi: 10.1016/j.joca.2024.01.007
pubmed: 38403152
Kurtz S, Ong K, Lau E, Mowat F, Halpern M (2007) Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg Am 89:780–785
doi: 10.2106/00004623-200704000-00012
pubmed: 17403800
Priemel M, von Domarus C, Klatte TO, Kessler S, Schlie J, Meier S, Proksch N, Pastor F, Netter C, Streichert T, Püschel K, Amling M (2010) Bone mineralization defects and vitamin D deficiency: histomorphometric analysis of iliac crest bone biopsies and circulating 25-hydroxyvitamin D in 675 patients. J Bone Miner Res 25:305–312
doi: 10.1359/jbmr.090728
pubmed: 19594303
Iglar PJ, Hogan KJ (2015) Vitamin D status and surgical outcomes: a systematic review. Patient Saf Surg 9:14
doi: 10.1186/s13037-015-0060-y
pubmed: 25926889
pmcid: 4413543
Vivek K, Kamal R, Perera E, Gupte CM (2024) Vitamin D deficiency leads to poorer health outcomes and greater length of stay after total knee arthroplasty and supplementation improves outcomes: a systematic review and meta-analysis. JBJS Rev 12:e23.00150
doi: 10.2106/JBJS.RVW.23.00150
pubmed: 38574186
pmcid: 10990007
Yeung Y, Chiu KY, Yau WP, Tang WM, Cheung WY, Ng TP (2006) Assessment of the proximal femoral morphology using plain radiograph-can it predict the bone quality? J Arthroplasty 21:508–513
doi: 10.1016/j.arth.2005.04.037
pubmed: 16781402
Rohe S, Böhle S, Matziolis G, Jacob B, Brodt S (2023) Plain radiographic indices are reliable indicators for quantitative bone mineral density in male and female patients before total hip arthroplasty. Sci Rep 13:19886
doi: 10.1038/s41598-023-47247-w
pubmed: 37963967
pmcid: 10645725
Jahresbericht Endoprothesenregister Deutschland (EPRD) 2023 https://www.eprd.de/fileadmin/user_upload/Dateien/Publikationen/Berichte/Jahresbericht2023-Status5_2023-10-24_F.pdf . Accessed 25 Apr 2024
Prieto-Alhambra D, Premaor MO, Fina Avilés F, Hermosilla E, Martinez-Laguna D, Carbonell-Abella C, Nogués X, Compston JE, Díez-Pérez A (2012) The association between fracture and obesity is site-dependent: a population-based study in postmenopausal women. J Bone Miner Res 27:294–300
doi: 10.1002/jbmr.1466
pubmed: 22095911
Hering RN, von Kroge S, Delsmann J, Simon A, Ondruschka B, Püschel K, Schmidt FN, Rolvien T (2024) Pronounced cortical porosity and sex-specific patterns of increased bone and osteocyte lacunar mineralization characterize the human distal fibula with aging. Bone 182:117068
doi: 10.1016/j.bone.2024.117068
pubmed: 38458304
Busse B, Djonic D, Milovanovic P, Hahn M, Püschel K, Ritchie RO, Djuric M, Amling M (2010) Decrease in the osteocyte lacunar density accompanied by hypermineralized lacunar occlusion reveals failure and delay of remodeling in aged human bone. Aging Cell 9:1065–1075
doi: 10.1111/j.1474-9726.2010.00633.x
pubmed: 20874757
Rolvien T, Milovanovic P, Schmidt FN, von Kroge S, Wölfel EM, Krause M, Wulff B, Püschel K, Ritchie RO, Amling M, Busse B (2020) Long-term immobilization in elderly females causes a specific pattern of cortical bone and osteocyte deterioration different from postmenopausal osteoporosis. J Bone Miner Res 35:1343–1351
doi: 10.1002/jbmr.3970
pubmed: 31999373
Wirth AJ, Goldhahn J, Flaig C, Arbenz P, Müller R, van Lenthe GH (2011) Implant stability is affected by local bone microstructural quality. Bone 49:473–478
doi: 10.1016/j.bone.2011.05.001
pubmed: 21609793
Busse B, Hahn M, Soltau M, Zustin J, Püschel K, Duda GN, Amling M (2009) Increased calcium content and inhomogeneity of mineralization render bone toughness in osteoporosis: mineralization, morphology and biomechanics of human single trabeculae. Bone 45:1034–1043
doi: 10.1016/j.bone.2009.08.002
pubmed: 19679206
Milovanovic P, Busse B (2020) Phenomenon of osteocyte lacunar mineralization: indicator of former osteocyte death and a novel marker of impaired bone quality? Endocr Connect 9:R70-r80
doi: 10.1530/EC-19-0531
pubmed: 32168472
pmcid: 7159263