Abstract
Non-traumatic osteonecrosis (ON) of the femoral head is a common disease affecting a young population as the peak age of diagnosis is in the 40 s. The natural history of non-traumatic ON leads to a collapse of the femoral head requiring prosthetic replacement in a 60% of cases. Although trabecular bone involvement in the collapse is suspected, the underlying modifications induced at a molecular level have not been explored in humans. Here, we examine changes in the molecular composition and structure of bone as evaluated by Raman spectroscopy in human end-stage ON. Comparing samples from femoral heads harvested from 11 patients and 11 cadaveric controls, we show that the mineral and organic chemical composition of trabecular bone in ON is not modified apart from age-related differences. We also show that the molecular composition in the necrotic part of the femoral head is not different from the composition of the remaining ‘healthy’ trabecular bone of the femoral head. These findings support that quality of trabecular bone is not modified during ON despite extensive bone marrow necrosis and osteocyte death observed even in the ‘healthy’ zones on histological examination.
Highlights
Non-traumatic osteonecrosis (ON) of the femoral head is a common disease with an estimated annual incidence of 3/100,000 in Europe[1] and up to 29/100,000 in Asia[2]
The bone mineral density (BMD) of osteonecrotic femoral heads was found to be decreased compared with matched controls[10, 11]
Raman spectroscopy can be performed on fresh samples using simple sample preparation to the contrary of other vibrational techniques analyzing bone composition such as Fourier transform infrared (FTIR)[23, 24]
Summary
Non-traumatic osteonecrosis (ON) of the femoral head is a common disease with an estimated annual incidence of 3/100,000 in Europe[1] and up to 29/100,000 in Asia[2]. Cancellous bone has been suspected to be responsible for the defective mechanical properties of the osteonecrotic femoral head[9] This suspicion led to explorations of trabecular bone quality during the course of ON using different techniques applied at University, F-59000, Lille, France. The molecular scale remains to be explored in depth, looking for local discrepancies, to provide a better understanding of bone quality alterations in affected bone. The mechanisms leading to the collapse of the femoral head and the anatomical extent of the altered bone remain unclear such that the structural evolution is still unpredictable[4]. The objective of this study was to examine modifications of the molecular composition and structure of bone as evaluated by Raman spectroscopy in human end-stage non-traumatic ON of the feoral head, and to search for relations with histological findings
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