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Microarchitecture Alternations of Osteochondral Junction in Patients with Osteonecrosis of the Femoral Head

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Abstract

The study was aimed to investigate microarchitecture of osteochondral junction in patients with osteonecrosis of the femoral head (ONFH). We hypothesis that there were microarchitecture alternations in osteochondral junction and regional differences between the necrotic region (NR) and adjacent non-necrotic region(ANR) in patients with ONFH. Femoral heads with ONFH or femoral neck fracture were included in ONFH group (n = 11) and control group (n = 11). Cylindrical specimens were drilled on the NR/ANR of femoral heads in ONFH group and matched positions in control group (CO.NR/ CO.ANR). Histology, micro-CT, and scanning electron microscope were used to investigate microarchitecture of osteochondral junction. Layered analysis of subchondral bone plate was underwent. Mankin scores on NR were higher than that on ANR or CO.NR, respectively (P < 0.001, P < 0.001). Calcified cartilage zone on the NR and ANR was thinner than that on the CO.NR and CO.ANR, respectively (P = 0.002, P = 0.002). Tidemark roughness on the NR was larger than that on the ANR (P = 0.002). Subchondral bone plate of NR and ANR was thicker than that on the CON.NR and CON.ANR, respectively (P = 0.002, P = 0.009). Bone volume fraction of subchondral bone plate on the NR was significantly decreasing compared to ANR and CON.NR, respectively (P = 0.015, P = 0.002). Subchondral bone plate on the NR had larger area percentages and more numbers of micropores than ANR and CON.NR (P = 0.002/0.002, P = 0.002/0.002). Layered analysis showed that bone mass loss and hypomineralization were mainly on the cartilage side of subchondral bone plate in ONFH. There were microarchitecture alternations of osteochondral junction in ONFH, including thinned calcified cartilage zone, thickened subchondral bone plate, decreased bone mass, altered micropores, and hypomineralization of subchondral bone plate. Regional differences in microarchitecture of osteochondral junction were found between necrotic regions and adjacent non-necrotic regions. Subchondral bone plate in ONFH had uneven distribution of bone volume fraction and bone mineral density, which might aggravate cartilage degeneration by affecting the transmission of mechanical stresses.

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Acknowledgements

We acknowledge the Molecular Testing Center of Xi'an Jiaotong University where scanning electron microscope (SEM) images were taken.

Funding

This work was supported by the National Natural Science Foundation of China [81772411] and Shaanxi Provincial Key R&D Programme [S2023-YF-YBSF-0229].

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Authors and Affiliations

  1. Department of Orthopedics, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an Jiaotong University, Xi’an, 710049, China

    Pengbo Wang, Xu Wang, Hang Qian, Jun Liu & Ruiyu Liu

  2. Department of Orthopedics, Xi’an Daxing Hospital, Xi’an, 710000, China

    Gang Liu

  3. Department of Orthopedics, Xi’an Fifth Hospital, Xi’an, 710000, China

    Ruisong Wang

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  1. Pengbo Wang
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  5. Gang Liu
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Contributions

PW, XW, HQ, and RL participated to the conception and design of the study, acquisition of data, analysis, and interpretation of data, drafted the article, or revised it critically for important intellectual content and gave their final approval of the version to be submitted. JL, GL, and RW participated to the harvest of materials, the acquisition, and interpretation of data.

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Correspondence to Ruiyu Liu.

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Conflicts of interest

Pengbo Wang, Xu Wang, Hang Qian, Jun Liu, Gang Liu, Ruisong Wang, and Ruiyu Liu declare that they have no conflicts of interest.

Human and Animal Rights

This study was approved by the ethical review Committee of the Second Affiliated Hospital of Xi'an Jiaotong University and was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments.

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All participants gave written-informed consent before entering the study.

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Wang, P., Wang, X., Qian, H. et al. Microarchitecture Alternations of Osteochondral Junction in Patients with Osteonecrosis of the Femoral Head. Calcif Tissue Int 114, 119–128 (2024). https://doi.org/10.1007/s00223-023-01153-5

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