Predictors of cartilage degeneration in patients with subchondral insufficiency fracture of the femoral head: a retrospective study

Abstract Background There is evidence that the cause of primary osteoarthritis (OA) is related to the changes in subchondral bone; however, it is not fully understood if subchondral insufficiency fracture (SIF) of the femoral head would affect degeneration of the hip joint and what the prognostic factors related to joint degeneration are. The objectives of this study were 1) to investigate the longitudinal joint space narrowing and 2) to investigate the associations between joint space narrowing and bone metabolic markers as well as magnetic resonance imaging (MRI) among the patients with SIF. Methods Between January 2010 and December 2019, 238 patients in whom band pattern of the femoral head were observed on MRI visited our hospital. Among these patients, 44 hips in 41 patients were diagnosed with SIF and eligible for this retrospective study. We evaluated the joint space width (JSW) of the hip on the radiograph obtained at the first and last visits, length of the band lesion on MRI, bone mineral density by dual-energy x-ray absorptiometry, and bone metabolism markers. We investigated the factors associated with the necessity of surgery and the progression of the narrowing of the joint space. Results Fifteen of the 44 hips required total hip arthroplasty (THA). The JSW showed a significant decrease from the first visit to the final follow-up. Changes in the JSW were associated with the length of band patterns, serum type 1 procollagen-N-propeptide (P1NP), and tartrate-resistant acid phosphatase 5b (TRACP-5b) at the date of diagnosis. Additionally, bone metabolic markers tended to be associated with the length of the band pattern. Conclusions SIF could cause joint space narrowing and hip OA. In addition to MRI findings as prognostic predictors of SIF, as previously described, bone metabolic markers were also associated with changes in JSW, suggesting that these parameters could be useful to predict the prognosis of SIF. Considering that bone metabolic markers trended to be associated with the length of band pattern, they might reflect the local severity.

Download Full-text

Predictors of cartilage degeneration in patients with subchondral insufficiency fracture of the femoral head: a retrospective study

10.21203/rs.3.rs-24081/v2 ◽

2020 ◽

Author(s):

Tomohiro Shimizu ◽

Sunichi Yokota ◽

Yosuke Kimura ◽

Tsuyoshi Asano ◽

Hirokazu Shimizu ◽

...

Keyword(s):

Femoral Head ◽

Joint Space Narrowing ◽

Insufficiency Fracture ◽

Joint Space Width ◽

Joint Space ◽

Band Pattern ◽

Bone Metabolic Markers ◽

Metabolic Markers ◽

Subchondral Insufficiency Fracture ◽

Space Width

Abstract Background: There is evidence that the cause of primary osteoarthritis (OA) is related to the changes in subchondral bone; however, the influence of subchondral insufficiency fracture (SIF) of the femoral head on the degeneration of the hip joint and the prognostic factors related to joint degeneration remain unclear. The objectives of this study were: 1) to investigate the natural history of joint space width after the occurrence of SIF and 2) to investigate the associations between joint space narrowing and bone metabolic markers as well as magnetic resonance imaging (MRI) among the patients with SIF.Methods: Between January 2010 and December 2019, 238 patients in whom band pattern of the femoral head were observed on MRI visited our hospital. Among these patients, 44 hips in 41 patients were diagnosed with SIF and eligible for this retrospective study. We evaluated the joint space width (JSW) of the hip on the radiograph obtained at the first and last visits, length of the band lesion on MRI, bone mineral density by dual-energy x-ray absorptiometry, and bone metabolism markers. Similarly, the factors associated with the necessity of surgery and the progression of the narrowing of the joint space were evaluated.Results: Fifteen of the 44 hips required total hip arthroplasty (THA). A significant decrease was observed in the JSW from the first visit to the final follow-up. Changes in the JSW were associated with the length of band patterns, serum type 1 procollagen-N-propeptide (P1NP), and tartrate-resistant acid phosphatase 5b (TRACP-5b) during diagnosis. Additionally, bone metabolic markers tended to be associated with the length of the band pattern. Conclusions: SIF could cause joint space narrowing and hip OA. In addition to MRI findings as prognostic predictors of SIF, as previously described, bone metabolic markers were equally associated with changes in JSW, suggesting that these parameters could be useful in predicting the prognosis of SIF. Considering that bone metabolic markers trended to be associated with the length of band pattern, they might reflect the local severity.

Download Full-text

Predictors of cartilage degeneration in patients with subchondral insufficiency fracture of the femoral head: a retrospective study

Arthritis Research & Therapy ◽

10.1186/s13075-020-02243-7 ◽

2020 ◽

Vol 22 (1) ◽

Author(s):

Tomohiro Shimizu ◽

Shunichi Yokota ◽

Yosuke Kimura ◽

Tsuyoshi Asano ◽

Hirokazu Shimizu ◽

...

Keyword(s):

Retrospective Study ◽

Femoral Head ◽

Insufficiency Fracture ◽

Cartilage Degeneration ◽

Subchondral Insufficiency Fracture

Download Full-text

Relationships between serum leptin level and regional bone mineral density, bone metabolic markers in healthy women

Acta Obstetricia Et Gynecologica Scandinavica ◽

10.3109/00016340009169264 ◽

2000 ◽

Vol 79 (12) ◽

pp. 1060-1064 ◽

Cited By ~ 1

Author(s):

Ichiro Iwamoto ◽

Tsutomu Douchi ◽

Shoichiro Kosha ◽

Masato Murakami ◽

Toshinori Fujino ◽

...

Keyword(s):

Bone Mineral Density ◽

Bone Mineral ◽

Mineral Density ◽

Bone Metabolic Markers ◽

Metabolic Markers ◽

Serum Leptin ◽

Healthy Women ◽

Regional Bone Mineral Density

Download Full-text

Correlation of serum uric acid with bone mineral density and bone metabolic markers in middle-aged Chinese physical examination population

Academic Journal of Second Military Medical University ◽

10.3724/sp.j.1008.2015.01056 ◽

2015 ◽

Vol 36 (10) ◽

pp. 1056

Author(s):

Wei-jun CHEN ◽

Jing XIAO ◽

Jia-nan ZOU ◽

Zhi-bin YE ◽

Li-min ZHANG ◽

...

Keyword(s):

Bone Mineral Density ◽

Uric Acid ◽

Physical Examination ◽

Serum Uric Acid ◽

Bone Mineral ◽

Middle Aged ◽

Mineral Density ◽

Bone Metabolic Markers ◽

Metabolic Markers

Download Full-text

Exercise Intervention to Improve the Bone Mineral Density and Bone Metabolic Markers as Risk Factors for Fracture in Japanese Subjects with Osteoporosis: a Systematic Review and Meta-analysis of Randomized Controlled Trials

Journal of Physical Therapy Science ◽

10.1589/jpts.24.1349 ◽

2012 ◽

Vol 24 (12) ◽

pp. 1349-1353 ◽

Cited By ~ 5

Author(s):

Ryo Tanaka ◽

Junya Ozawa ◽

Takuya Umehara ◽

Nobuhiro Kito ◽

Takahiro Yamasaki ◽

...

Keyword(s):

Risk Factors ◽

Bone Mineral Density ◽

Exercise Intervention ◽

Meta Analysis ◽

Controlled Trials ◽

Mineral Density ◽

Bone Metabolic Markers ◽

Metabolic Markers ◽

Randomized Controlled ◽

Japanese Subjects

Download Full-text

High systemic bone mineral density increases the risk of incident knee OA and joint space narrowing, but not radiographic progression of existing knee OA: the MOST study

Annals of the Rheumatic Diseases ◽

10.1136/ard.2008.099531 ◽

2009 ◽

Vol 69 (01) ◽

pp. 163-168 ◽

Cited By ~ 68

Author(s):

M C Nevitt ◽

Y Zhang ◽

M K Javaid ◽

T Neogi ◽

J R Curtis ◽

...

Keyword(s):

Bone Mineral Density ◽

Bone Mineral ◽

Joint Space Narrowing ◽

Weight Bearing ◽

Joint Space ◽

Whole Body ◽

Mineral Density ◽

Knee Oa ◽

Increased Risk

Objectives:Previous studies suggest that high systemic bone mineral density (BMD) is associated with incident knee osteoarthritis (OA) defined by osteophytes but not with joint space narrowing (JSN), and are inconsistent regarding BMD and progression of existing OA. The association of BMD with incident and progressive tibiofemoral OA was tested in a large prospective study of men and women aged 50–79 years with or at risk for knee OA.Methods:Baseline and 30-month weight-bearing posteroanterior and lateral knee radiographs were scored for Kellgren-Lawrence (K-L) grade, JSN and osteophytes. Incident OA was defined as the development of K-L grade ⩾2 at follow-up. All knees were classified for increases in grade of JSN and osteophytes from baseline. The association of gender-specific quartiles of baseline BMD with risk of incident and progressive OA was analysed using logistic regression, adjusting for covariates.Results:The mean (SD) age of 1754 subjects was 63.2 (7.8) years and body mass index was 29.9 (5.4) kg/m2. In knees without baseline OA, higher femoral neck and whole body BMD were associated with an increased risk of incident OA and increases in grade of JSN and osteophytes (p<0.01 for trends); adjusted odds were 2.3–2.9-fold greater in the highest compared with the lowest BMD quartiles. In knees with existing OA, progression was not significantly related to BMD.Conclusions:In knees without OA, higher systemic BMD was associated with a greater risk of the onset of JSN and K-L grade ⩾2. The role of systemic BMD in early knee OA pathogenesis warrants further investigation.

Download Full-text