Abstract
BackgroundThere 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.MethodsBetween January 2010 and December 2019, 238 patients in whom band pattern of the femoral head were observed on MRI visited Hokkaido University 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.ResultsFifteen 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.ConclusionsSIF 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.
Highlights
There is evidence that the cause of primary osteoarthritis (OA) is related to the changes in subchondral bone; 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
Subchondral insufficiency fracture (SIF) of the femoral head has recently been recognized as a cause of the femoral head collapse, resulting in the degeneration of the hip joint, which is known to occur in association with osteonecrosis of the femoral head (ONFH) [1,2,3]
There is evidence that the cause of primary OA is related to the changes in subchondral bone [9, 10], the influence of SIF on the degeneration of the hip joint and the prognostic factors related to joint degeneration among patients with SIF remain unclear
Summary
There is evidence that the cause of primary osteoarthritis (OA) is related to the changes in subchondral bone; 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. There is evidence that the cause of primary OA is related to the changes in subchondral bone [9, 10], the influence of SIF on the degeneration of the hip joint and the prognostic factors related to joint degeneration among patients with SIF remain unclear. Bone fragility due to osteoporosis could be considered the most important cause of SIF, similar to vertebral body fractures [19], another study reported no differences in bone mass densitometry (BMD) between patients with and without (controls) SIF [20]. Evaluating whether and how bone turnover markers would affect the pathology of SIF would be of significant interest
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
