Regional variation of intracortical porosity in the midshaft of the human femur: age and sex differences

Abstract

This study investigated age and sex differences in patterns of porosity distribution in the midshaft of the human femur. Cross-sections were obtained from 168 individuals from a modern Australian population. The sample comprised 73 females and 95 males, aged between 20 and 97 years. Microradiographs were made of 100-microm sections and pore and bone areas were determined using image processing software. Initially the sample was divided by age: young (20-44 years), middle (45-64 years) and old (65+ years), but it was found that analysis on the basis of the ratio of medullary area to total subperiosteal area gave clearer results. The cortex was divided into three rings radially and into octants circumferentially and the porosity of each segment was calculated. Results showed that a pattern with raised porosity in the posterior and anterolateral regions, and with greater porosity in the inner parts of the cortex, becomes more pronounced with age. In males this pattern develops steadily; in females there are much greater differences between the middle and older groups than earlier in life. The patterns observed are consistent with progressive bone loss occurring along a neutral axis of the cortex where bending stress is lowest and the mechanical advantage of the bone is least.

Fig. 1

Subdivisions of the cortex. A, anterior; AL, anterolateral; L, lateral; PL, posterolateral; P, posterior; PM, posteromedial; M, medial; AM, anteromedial. The three rings shown will be referred to as periosteal, midcortical and endosteal.

Fig. 2

Porosity distribution around the cortex, with specimens grouped by age: (a–c) males, (d–f) females. The upper pair is for the periosteal ring (note different vertical scales), the middle pair for the midcortical and the lower pair for the endosteal ring. Solid symbols indicate significant difference at P  = 0.05 from the posterior octant within each group.

Fig. 3

Porosity distribution around the cortex, with specimens grouped by MA/TSPA ratio. Solid symbols indicate significant difference at P  = 0.05 from the posterior octant within each group. Graphs are for females only: (a) data from the midcortical and (b) data from the endosteal rings. (a) and (b) should be compared with Fig. 2(e) and (f), respectively.

Fig. 4

Differences (percentage points) between porosities in males and females (males minus females) in all subdivisions: (a) Young (20–44 years), (b) middle age (45–64 years), (c) old (65 and older), (d) low MA/TSPA, (e) middle MA/TSPA, (f) high MA/TSPA. Text annotations on the graphs: a indicates significance at P  = 0.05, and b at P  = 0.1.