Variations in bone microarchitecture in the osteoporotic hip fracture area

Objective To evaluate the changes of trabeculae microstructure in the tensional side of the hip fracture area.Methods Sixteen elderly patients with low-energy femoral neck fractures and undergone arthroplasty were selected in the experimental group.Bone mineral density of the healthy side of the hip was examined before the operation.Five femurs in control group were obtained from 5 young cadavers due to difficult sample collection.Trabecular specimens of 5 mm × 5 mm × 10 mm were obtained from the tensional side of femoral neck trabeculae in both experiment and control group.The difference of microstructure between the 2 groups and the correlation between microstructure parameters and BMD of patients in experiment group were analyzed.Results Microstructure in the experimental gourp:Bone volume / tissue volume(BV /TV) 0.0645 ± 0.0259,trabecular number(Tb.N)(0.8078 ±0.2212) mm-1,trabecular thickness(Tb.Th)(0.0836 ±0.0212) mm,trabecular spacing(Tb.Sp)(1.2197± 0.4492) mm,connect density(Conn.D) 1.8577 ± 1.0217,structure mode index(SMI) 1.778 ± 0.5168.Microstructure in the control group :BV /TV 0.1470 ± 0.0633,Tb.N(1.2692 ± 0.1376) mm-1,Tb.Th(0.1201 ±0.0414) mm,Tb.Sp(0.6810 ±0.1129) mm,Conn.D 3.3585 ± 1.7851,SMI 0.8781 ± 0.6665.Comparing to control group,the trabecular of the tensional side in experiment group was obviously destroyed.All the microstructure parameters were altered obviously,and the changes were statistically significant(P 0.05).No correlation was found between microstructure parameters and BMD in experiment group(P 0.05).Conclusion The microstructure of the trabecular in the tensional side of the hip is deteriorated in patients with osteoporosis.This may be one of the important causes of the hip fracture.