Abstract
BackgroundFemoral neck fractures are a common occurrence in patients suffering from osteoporosis, while intracapsular hip fracture is rare in cases of osteoarthritis of the hip. Previous histomorphometric studies have emphasized the association between bone microarchitecture and the risk of low-impact fractures in osteoarthritis and osteoporosis patients. However, the strength of bone material is also a function of composition of organic bone matrix. In order to compare tissue material properties in these two clinical conditions, serum and bone pentosidine, a non-enzymatic collagen crosslinking element, was measured in patients who suffered a low-impact fracture, and in patients with advanced osteoarthritis.MethodsThe patient population consisted of 70 patients who underwent hemiarthroplasty surgery for a femoral neck fracture, and 41 patients with advanced hip joint osteoarthritis without a history of low- impact fracture, who were indicated for total hip joint replacement. Pentosidine content was analyzed in bone samples and in serum obtained from fracture and osteoarthritis patients using high performance liquid chromatography.ResultsSerum and bone concentrations of pentosidine were higher in subjects with hip fractures compared with osteoarthritis after adjustment for age, sex, weight, serum creatinine, and diabetes. A significant positive correlation was found between bone and serum pentosidine in fractured cases. A comparable relationship was also demonstrated for pentosidine levels in serum and bone relative to differentiation of fracture and osteoarthritis cases.ConclusionsSerum pentosidine can be considered a potential biomarker for identification of subjects with impaired bone quality and bone strength.
Highlights
Femoral neck fractures are a common occurrence in patients suffering from osteoporosis, while intracapsular hip fracture is rare in cases of osteoarthritis of the hip
Increased content of PEN in cortical and trabecular bone was associated with impairment of bone quality in osteoporotic patients with hip fractures [18], while plasma PEN levels were not increased in patients with osteoarthritis compared with controls [19]
The group with hip joint osteoarthritis, which was without a history of low energy fractures, included 41 patients in advanced stages of hip osteoarthritis, who were indicated for total hip joint replacement, 63 % of the atrophic type, 24 % of the hypertrophic type [20]
Summary
Femoral neck fractures are a common occurrence in patients suffering from osteoporosis, while intracapsular hip fracture is rare in cases of osteoarthritis of the hip. In order to compare tissue material properties in these two clinical conditions, serum and bone pentosidine, a non-enzymatic collagen crosslinking element, was measured in patients who suffered a low-impact fracture, and in patients with advanced osteoarthritis. Bone strength is determined by the degree of mineralization of basic structural units, microdamage accumulation, and properties of the organic bone matrix, namely collagen cross-link formation [1, 2]. These are regulated by cellular activities and tissue turnover rate [3]. Serum and bone PEN has not been compared previously in patients with hip osteoarthritis and low-impact hip fractures
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