髋关节骨关节炎与健康对照组患者股骨颈小梁微结构的增强：绝经后女性的微计算机断层扫描研究。
Enhanced trabecular micro-architecture of the femoral neck in hip osteoarthritis vs. healthy controls: a micro-computer tomography study in postmenopausal women.
机构信息
Institute of Anatomy, University of Belgrade, Belgrade, Serbia.
出版信息
Int Orthop. 2013 Jan;37(1):21-6. doi: 10.1007/s00264-012-1713-4. Epub 2012 Nov 24.
PURPOSE
A controversial relationship between osteoarthritis (OA) and bone fragility has been attracting considerable attention. However, despite interest in the effects of OA on femoral neck fracture risk and numerous studies analysing the changes in the arthritic femoral head, there is insufficient data about femoral neck 3D bone micro-architecture in individuals with hip osteoarthritis. We compared trabecular micro-architecture of the femoral neck between postmenopausal women with coxarthrosis and controls to explore whether coxarthrosis may indicate reduced bone fragility from the trabecular micro-architectural perspective.
METHODS
The study sample included nine women with hip osteoarthritis and 13 age-matched controls. The femoral neck sections were scanned using micro-computed tomography, evaluating the cancellous bone from the superolateral and inferomedial neck subregions.
RESULTS
Osteoarthritic subjects demonstrated a general trend of improved trabecular micro-architecture in both analysed subregions when compared with age-matched controls. In particular, several architectural properties that are important predictors of cancellous bone strength showed significantly better values in the OA group, even after adjusting for bone volume fraction. Namely, the OA group expressed higher trabecular connectivity (p = 0.008), lower SMI indicating more plate-like structure (p = 0.005), and reduced anisotropy (p = 0.006) particularly in the inferomedial neck. Osteoarthritic cases also trended towards higher BV/TV, particularly in the superolateral neck. All micro-architectural parameters displayed significant regional heterogeneity (p ≤ 0.01), with the inferomedial neck region showing more favourable values than the superolateral region.
CONCLUSIONS
Enhanced trabecular micro-architecture of the femoral neck in postmenopausal osteoarthritic subjects suggests reduced cancellous bone fragility in comparison with their age-matched healthy controls.
目的
骨关节炎（OA）与骨脆弱之间存在争议的关系引起了相当大的关注。然而，尽管人们对 OA 对股骨颈骨折风险的影响以及许多分析关节炎股骨头变化的研究感兴趣，但关于髋 OA 个体股骨颈 3D 骨微观结构的数据仍然不足。我们比较了绝经后髋关节炎患者和对照组股骨颈的小梁微观结构，以探讨从小梁微观结构的角度来看，髋关节炎是否可能表明骨脆性降低。
方法
研究样本包括 9 名髋关节炎女性和 13 名年龄匹配的对照组。使用微计算机断层扫描扫描股骨颈节段，评估来自超外侧和中内侧颈亚区的松质骨。
结果
与年龄匹配的对照组相比，OA 患者在两个分析亚区的小梁微观结构均表现出改善的总体趋势。特别是，在 OA 组中，几个对松质骨强度有重要预测作用的结构特性表现出明显更好的值，即使在调整了骨体积分数后也是如此。即，OA 组的骨小梁连接性更高（p=0.008），表示更板状结构的 SMI 更低（p=0.005），各向异性降低（p=0.006），尤其是在中内侧颈。OA 病例也倾向于具有更高的 BV/TV，尤其是在超外侧颈。所有微观结构参数均显示出显著的区域异质性（p≤0.01），中内侧颈区域的数值比超外侧颈区域更有利。
结论
与年龄匹配的健康对照组相比，绝经后 OA 患者股骨颈的小梁微观结构增强表明松质骨脆性降低。
Zotero 插件