Composition and characteristics of trabecular bone in osteoporosis and osteoarthritis

Tamimi, Iskandar<sup>1</sup>; Cortes, Arthur Rodríguez González<sup>2,3</sup>; Sánchez-Siles, Juan-Manuel<sup>1</sup>; Ackerman, Jerome L.<sup>2</sup>; González-Quevedo, David<sup>1</sup>; García, Ángel<sup>1</sup>; Yaghoubi, Farid<sup>4</sup>; Abdallah, Mohamed-Nur<sup>4</sup>; Eimar, Hazem<sup>5</sup>; Alsheghri, Ammar<sup>6</sup>; Laurenti, Marco<sup>7</sup>; Al-Subaei, Ahmad<sup>4</sup>; Guerado, Enrique<sup>8</sup>; García-de-Quevedo, David<sup>1</sup>; Tamimi, Faleh<sup>4</sup>

Affiliations

¹Department of Orthopedic Surgery, Regional University Hospital of Málaga, Spain

²Department of Radiology, Massachusetts General Hospital, Charlestown, USA

³Department of Dental Surgery, Faculty of Dental Surgery, University of Malta

⁴Faculty of Dentistry, McGill University Montreal, Canada

⁵Faculty of Medicine and Dentistry, University of Alberta, Canada

⁶Department of Mining and Materials Engineering, McGill University, Montreal, Canada

⁷Faculty of Pharmacy, Complutense University of Madrid, Spain

⁸Faculty of Medicine, University of Málaga, Spain

Abstract and keywords

Background: Bone strength depends on multiple factors such as bone density, architecture and composition turnover. However, the role these factors play in osteoporotic fractures is not well understood.

Purpose: The aim of this study was to analyze trabecular bone architecture, and its crystal and organic composition in humans, by comparing samples taken from patients who had a hip fracture (HF) and individuals with hip osteoarthritis (HOA).

Methods: The study included 31 HF patients and 42 cases of HOA who underwent joint replacement surgery between 1/1/2013 and 31/12/2013. Trabecular bone samples were collected from the femoral heads and analyzed using a dual-energy X-ray absorptiometry, micro-CT, and solid-state high-resolution magic-angle-spinning nuclear magnetic resonance (MAS-NMR) spectroscopy.

Results: No differences in proton or phosphorus concentration were found between the two groups using ¹H single pulse, ³¹P single pulse, ³¹P single pulse with proton decoupling NMR spectroscopy, in hydroxyapatite (HA) c-axis or a-axis crystal length. Bone volume fraction (BV/TV), trabecular number (Tb.N), and bone mineral density (BMD) were higher in the HO group than in the HF group [28.6% ± 10.5 vs 20.3% ± 6.6 (p = 0.026); 2.58 mm⁻¹ ± 1.57 vs 1.5 mm⁻¹ ± 0.79 (p = 0.005); and 0.39 g/cm² ± 0.10 vs. 0.28 g/cm² ± 0.05 (p = 0.002), respectively]. The trabecular separation (Tp.Sp) was lower in the HO group 0.42 mm ± 0.23 compared with the HF group 0.58 mm ± 0.27 (p = 0.036). In the HO group, BMD was correlated with BV/TV (r = 0.704, p < 0.001), BMC (r = 0.853, p < 0.001), Tb.N (r = 0.653, p < 0.001), Tb.Sp (−0.561, p < 0.001) and 1H concentration (−0.580, p < 0.001) in the HO group. BMD was not correlated with BV/TV, Tb.Sp, Tb.Th, Tb.N, Tb.PF, 1H concentration or HA crystal size in the HF group.

Conclusions: Patients with HO who did not sustain previous hip fractures had a higher femoral head BMD, BV/TV, and Tb.N than HF patients. In HO patients, BMD was positively correlated with the BV/TV and Tb.N and negatively correlated with the femoral head organic content and trabecular separation. Interestingly, these correlations were not found in HF patients with relatively lower bone densities. Therefore, osteoporotic patients with similar low bone densities could have significant microstructural differences. No differences were found between the two groups at a HA crystal level.

Keywords: Micro-computed tomography; Nuclear magnetic resonance; Femoral head bone fractures; Osteoporosis; Hydroxyapatite; Crystal; Structure

Links

DOI: 10.1016/j.bone.2020.115558

PubMed: 32730941

WoS: 000572849900007

History

Received: 2020-01-9

Revised: 2020-07-7

Accepted: 2020-07-7

Online: 2020-07-27

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Year	Entry
2024	Schadow JE, Maxey D, Smith TO, Finnilä MA, Manske SL, Segal NA, Wong AKO, Davey RA, Turmezei T, Stok KS. Systematic review of computed tomography parameters used for the assessment of subchondral bone in osteoarthritis. Bone. January 2024;178:116948.
2024	Hilliquin S, Zhukouskaya V, Fogel O, Cherifi C, Ibrahim K, Slimani L, Cornelis FMF, Storms L, Hens A, Briot K, Lories R, Chaussain C, Miceli-Richard C, Bardet C. The sacroiliac joint: an original and highly sensitive tool to highlight altered bone phenotype in murine models of skeletal disorders. Bone. January 2024;178:116931.