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. 2012 Mar;27(3):672-8.
doi: 10.1002/jbmr.560.

Reduced cortical bone compositional heterogeneity with bisphosphonate treatment in postmenopausal women with intertrochanteric and subtrochanteric fractures

Eve Donnelly  1 , Dennis S Meredith, Joseph T Nguyen, Brian P Gladnick, Brian J Rebolledo, Andre D Shaffer, Dean G Lorich, Joseph M Lane, Adele L Boskey
Affiliations

Reduced cortical bone compositional heterogeneity with bisphosphonate treatment in postmenopausal women with intertrochanteric and subtrochanteric fractures

Eve Donnelly et al. J Bone Miner Res. 2012 Mar.

Abstract

Reduction of bone turnover with bisphosphonate treatment alters bone mineral and matrix properties. Our objective was to investigate the effect of bisphosphonate treatment on bone tissue properties near fragility fracture sites in the proximal femur in postmenopausal women with osteoporosis. The mineral and collagen properties of corticocancellous biopsies from the proximal femur were compared in bisphosphonate-naive (-BIS, n = 20) and bisphosphonate-treated (+BIS, n = 20, duration 7 ± 5 years) patients with intertrochanteric (IT) and subtrochanteric (ST) fractures using Fourier transform infrared imaging (FTIRI). The mean values of the FTIRI parameter distributions were similar across groups, but the widths of the parameter distributions tended to be reduced in the +BIS group relative to the -BIS group. Specifically, the widths of the cortical collagen maturity and crystallinity were reduced in the +BIS group relative to those of the -BIS group by 28% (+BIS 0.45 ± 0.18 versus -BIS 0.63 ± 0.28, p = 0.03) and 17% (+BIS 0.087 ± 0.012 versus -BIS 0.104 ± 0.036, p = 0.05), respectively. When the tissue properties were examined as a function of fracture morphology within the +BIS group, the FTIR parameters were generally similar regardless of fracture morphology. However, the cortical mineral:matrix ratio was 8% greater in tissue from patients with atypical ST fractures (n = 6) than that of patients with typical (IT or spiral ST) fractures (n = 14) (Atypical 5.6 ± 0.3 versus Typical 5.2 ± 0.5, p = 0.03). Thus, although the mean values of the FTIR properties were similar in both groups, the tissue in bisphosphonate-treated patients had a more uniform composition than that of bisphosphonate-naive patients. The observed reductions in mineral and matrix heterogeneity may diminish tissue-level toughening mechanisms.

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Conflict of interest statement

Disclosures: JML consults for Amgen, BioMimetic Therapeutics, Inc., Bone Therapeutics, SA, CollPlant, Ltd., Graftys SA, and Zimmer; is a member of the Scientific Advisory Board of D'Fine, Inc. and Zimmer; and serves on the Speakers Bureau for Eli Lilly, Novartis, and Warner Chilcott. All other authors state that they have no conflicts of interest.

Figures

Figure 1
Figure 1
Representative FTIR images and associated pixel histograms with Gaussian fits of (a) collagen maturity and (b) crystallinity for bisphosphonate-naïve (-BIS) and bisphosphonate-treated (+BIS) cortical bone. The mean and the full width at half maximum (FWHM) values of the Gaussian curves are indicated on each histogram.
Figure 2
Figure 2
Cortical and trabecular FTIR properties for bisphosphonate-naïve (-BIS) and bisphosphonate-treated (+BIS) groups reported as image pixel distribution (a) means and (b) full widths at half maximum (FWHM). Error bars indicate standard deviations. FTIR properties are mineral:matrix ratio (MM), carbonate:phosphate ratio (CP), collagen maturity (XLR), and crystallinity (XST); * p < 0.05 vs. -BIS by t-test.
Figure 3
Figure 3
FTIR properties of cortical and trabecular bone from bisphosphonate-naïve (-BIS) and bisphosphonate-treated (+BIS) groups reported as image pixel distribution (a) means and (b) full widths at half maximum (FWHM) and plotted according to fracture morphology: typical (intertrochanteric or spiral subtrochanteric) or atypical subtrochanteric(13). # p < 0.05 vs. Typical by Mann-Whitney U test.
See this image and copyright information in PMC

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