Femoral subchondral bone properties of patients with cam-type femoroacetabular impingement

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• 作者：I. Haider^&dagger ; ; ^{ifaz.haider@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; A. Speirs^&dagger ; ; ^{andrew.speirs@carleton.ca" class="auth_mail" title="E-mail the corresponding author} ; A. Alnabelseya^&dagger ; ; ^{aalnabel@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; P.E. Beaulé ; ^&Dagger ; ; ^{pbeaule@ottawahospital.on.ca" class="auth_mail" title="E-mail the corresponding author} ; H. Frei^&dagger ; ; ^{hanspeter.frei@carleton.ca" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Femoroacetabular impingement ; Tissue modulus ; Finite element ; Subchondral bone
• 刊名：Osteoarthritis and Cartilage
• 出版年：2016
• 出版时间：June 2016
• 年：2016
• 卷：24
• 期：6
• 页码：1000-1006
• 全文大小：1027 K

文摘

Morphological deformities of the hip, such as femoroacetabular impingement (FAI) may be responsible for up to 80% of hip osteoarthritis. In cam type FAI, the pathomechanism has been attributed to repeated abnormal contact between the femur and the antero-superior acetabular rim, resulting in cartilage and labrum degeneration. Subchondral bone stiffness likely plays a major role in the process, but little is known of the mechanical properties of the cam deformity. The purpose of this study was to determine tissue modulus and the trabecular micro-architecture of the subchondral bone of the cam deformity of patients undergoing resection surgery as well as comparing these parameters to healthy aged matched controls.

Design

Twelve osteochondral bone biopsies were obtained from symptomatic FAI patients and ten osteochondral control specimens were harvested from cadaveric femurs. A combination of mechanical testing, micro-CT and finite element (FE) analysis were used to determine tissue modulus, bone volume fraction, trabecular thickness, trabecular and spacing, and trabecular number.

Results

The mean tissue modulus of the cam-type FAI deformities (E = 5.4 GPa) was significantly higher than normal controls (E = 2.75 GPa, P = 0.038), but no statistically significant differences were found in bone micro-architectural parameters.

Conclusions

The data suggests that subchondral bone of the cam deformity consists of older secondary mineralized bone. This supports the notion that the cam deformity is a primary malformation with intrinsic biomechanical abnormalities rather than a secondary deformity as part of the degenerative process of the covering cartilage or remodeling due to repeated impingement.