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. 2017 Oct 17;7(1):13345.
doi: 10.1038/s41598-017-13643-2.

Bone Microarchitecture and Biomechanics of the Necrotic Femoral Head

Jian-Xiong Ma  1   2   3 , Wei-Wei He  1   2   3 , Jie Zhao  1   2   3 , Ming-Jie Kuang  1   2   3 , Hao-Hao Bai  1   2   3 , Lei Sun  1   2 , Bin Lu  1   2 , Ai-Xian Tian  1   2 , Ying Wang  1   2 , Ben-Chao Dong  1   2 , Yan Wang  1   2 , Xin-Long Ma  4   5
Affiliations

Bone Microarchitecture and Biomechanics of the Necrotic Femoral Head

Jian-Xiong Ma et al. Sci Rep. .

Abstract

The mechanism behind osteonecrosis of the femoral head (ONFH) remains unclear. The aim of this study was to explore the pathogenesis of ONFH from a biomechanical standpoint to provide a theoretical basis for improved treatments. We compared the bone structure of fractured femoral heads with that of necrotic femoral heads by Micro-CT scanning and histological evaluation. In addition, we compared the biomechanical properties of each zone in fractured femoral heads with those in necrotic femoral heads by using biomechanical tests. Compared with fractured femoral heads, bone microarchitecture and bone morphometry in necrotic zone and sclerotic zone of necrotic femoral heads have altered markedly. In addition, the biomechanical properties of the necrotic zone in femoral heads weaken markedly, while those of the sclerotic zone strengthen. We hypothesize that discordance between bone structure and function of the femoral head may be involved in the pathogenesis of ONFH and that more attention should be paid to the prevention and treatment of such discordance.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
Anteroposterior X-ray of included patients. (A) Femoral neck fracture; (B) Femoral head necrosis.
Figure 2
Figure 2
Coronal plane and reconstructed 3-D structure of the fractured femoral head. (A) Proximal compressive trabeculae zone; (B) Junctional zone; (C) Distal compressive trabeculae zone; (D) Tensile trabeculae zone.
Figure 3
Figure 3
Coronal plane and reconstructed 3-D structure of the necrotic femoral head. (A) Necrotic zone; (B) Sclerotic zone; (C) Distal compressive trabeculae zone; (D) Tensile trabeculae zone.
Figure 4
Figure 4
Results of bone morphometry of each zone in the fractured and necrotic femoral head. (A) Bone volume/total volume; (B) Trabecular number; (C) Trabecular separation; (D) Trabecular thickness. Data is presented as a mean ± standard deviation PCTZ = proximal compressive trabeculae zone, NZ = necrotic zone, JZ = junctional zone, SZ = sclerotic zone, DCTZ = distal compressive trabeculae zone, TTZ = tensile trabeculae zone; *P < 0.05.
Figure 5
Figure 5
Hematoxylin and eosin staining of hard tissue slices for the fractured femoral head. (A) Cartilage (×40). (B) Trabeculae in junctional zone (×40). (C) Bone lacunae in trabeculae zone (×400). (D) Bone marrow (×40). (E) Hard tissue slice for fractured femoral head.
Figure 6
Figure 6
Hematoxylin and eosin staining of hard tissue slice for the necrotic femoral head. (A) Cartilage (×40); (B) Necrotic zone (×40); (C) Bone lacunae in trabeculae zone (×400); (D) Bone marrow (×40); (E) Hard tissue slice for fractured femoral head.
Figure 7
Figure 7
Results of biomechanical test of bone block in each zone. (A) Elastic modulus; (B) Yield strength; (C) Ultimate strength. Data is presented as a mean ± standard deviation. PCTZ = proximal compressive trabeculae zone, NZ = necrotic zone, JZ = junctional zone, SZ = sclerotic zone, DCTZ = distal compressive trabeculae zone, TTZ = tensile trabeculae zone; *P < 0.05.
Figure 8
Figure 8
The cubic bone block.
Figure 9
Figure 9
Biomechanical test of the bone block.
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