Advances in Clinical and Experimental Medicine
2020, vol. 29, nr 1, January, p. 51–61
Publication type: original article
Micromorphological assessment of bone tissue remodeling in various hip degeneration conditions
1 Clinic of Orthopedics and Traumatology, Department of Regenerative and Restoration Medicine in Orthopedics, Wroclaw Medical University, Poland
2 Department of Animals Biostructure and Physiology, Faculty of Veterinary Medicine, Wrocław University of Environmental and Life Sciences, Poland
3 District Hospital of Orthopedics and Trauma Surgery, Department of the Knee Surgery, Arthroscopy and Sports Traumatology, Piekary Śląskie, Poland
Background. The reorganization of bone tissue is closely associated with its metabolism and changes in its internal structure. Metabolism of the bone, which results from the simultaneous processes of resorption and formation of new bone tissue, may depend on the presence and type of arthritis.
Objectives. The objective of the study was to assess, based on the morphological features and mineral composition of bone tissue, changes in the femoral head in various types of hip joint degeneration.
Material and Methods. The study group consisted of 21 patients surgically treated for hip joint degeneration. They included 17 women, aged 30–70 years (mean age 52.5 years), and 4 men, aged 38–51 (mean age 48.5 years). The assessment of the morphological condition of the bone and the mineral composition of bone tissue took into account quantitative and qualitative relationships among the mineral components and bone matrix. The structure of spongious bone tissue was analyzed in histological studies, with special attention paid to osteogenesis and osteoclastic processes and the advancement of degeneration.
Results. Three main types of degenerative changes in bone tissue of the examined femoral head were recognized: osteoporosis with a prevalence of coarse-fiber bone tissue and decreased osteogenic activity; osteolysis with few osteogenesis centers; and intensified reorganization of bone tissue. In more than half of the examined samples, coarse-fiber bone tissue was replaced by newly formed bone tissue. We observed bone resorption and osteogenesis, which indicate normal homeostasis of the bone tissue. Uneven saturation of spongious bone with mineral components was found. The content of organic and inorganic bone components measured with Ca : P and C : Ca + P ratios had similar values in all types of changes. Only the bone with intense osteolysis contained a smaller quantity of carbon (4.96–8.13%).
Conclusion. Our observations indicate an intense adaptive reorganization of bone tissue depending on external and internal factors, including biomechanical condition.
bone, remodeling, micromorphometry, hip joint degeneration
- Wolff J. The Law of Bone Remodeling. Berlin, West Germany: Springer Verlag; 1986.
- Frost HM. Skeletal structural adaptations to mechanical usage (SATMU). 1. Redefining Wolff’s law: The bone modeling problem. Anat Rec. 1990;226(4):403–413.
- Frost HM. Perspectives on artificial joint design. J Long Term Eff Med Implants. 1992;2(1):9–35.
- Frost HM. Wolff’s law and bone’s structural adaptations to mechanical usage: An overview for clinicians. Angle Orthod. 1994;64(3):175–188.
- Busse J, Gasteiger W, Tönnis D. Eine neue Methode zur röntgenologischen Beurteilung eines Hüftgelenkes – Der Hüftwert. Arch Orthop Trauma Surg. 1972;72(1):1–9.
- Owan I, Burr DB, Tuner CH, et al. Mechanotransduction in bone: Osteoblastem are more responsive to fluid forces than mechanical strain. Am J Phys. 1997;273(3 Pt 1):810–815.
- Fyhrie DP, Kimura JH. Cancellous bone biomechanics. J Biomech. 1999;32(11):1139–1148.
- Fyhrie DP, Schaffer MB. The adaptation of bone apparent density to applied load. J Biomech. 1995;28(2):135–146.
- Hert J. Reaction of bone to mechanical stimuli. Part 3. Microstructure of compact bone of rabbit tibia after intermittent loading. Acta Anat (Basel). 1972;82(2):218–230.
- Lanyon LE. Control of bone architecture by functional load bearing. J Bone Miner Res. 1992;7(Suppl 2):369–375.
- Minster J. Modelling of viscoelastic deformation of cortical bone tissue. Acta Bioengineering Biomechanics. 2003;5(1):11–20.
- O’Connor JA, Lanyon LE, MacFie H. The influence of strain rate on adaptive bone remodeling. J Biomech. 1982;15(10):767–781.
- Rizzoli R, Bianchi ML, Garabédian M, McKay HA, Moreno LA. Maximizing bone mineral mass gain during growth for the prevention of fractures in the adolescents and the elderly. Bone. 2010;46(2):294–305.
- Kolundžić R, Trkulja V, Mikolaučić M, Jovanić Kolundžić M, Pavelić SK, Pavelić K. Association of interleukin-6 and transforming growth factor-β1 gene polymorphisms with developmental hip dysplasia and severe adult hip osteoarthritis: A preliminary study. Cytokine. 2011;54(2):125–128.
- Engh CA, Hooten JP Jr, Zettl-Schaffer KF, et al. Porous-coated total hip replacement. Clin Orthop Relat Res. 1994;298:89–96.
- Marczyński W. Leczenie zaburzeń zrostu i ubytków tkanki kostnej. Warszawa, Poland: Wydawnictwo Bellona; 1995.
- Davidson JA. Characteristics of metal and ceramic total hip bearing surfaces and their effect on long-term ultra-high molecular weight polyethylene wear. Clin Orthop Relat Res. 1993;294:361–378.
- Katz RL, Bourne RB, Rorabeck CH, McGee H. Total hip arthroplasty in patients with avascular necrosis of the hip: Follow-up observations on cementless and cemented operations. Clin Orthop Relat Res. 1992;281:145–151.
- Lees S, Davidson CL. The role of collagen in the elastic properties of calcified tissues. J Biomech. 1977;10(8):473–486.
- Beaupré GS, Orr TE, Carter DR. An approach for time-dependent bone modeling and remodeling: Theoretical development. J Orthop Res. 1990;8(5):651–661.
- McLean FC, Budy AM. The mineral of bones and teeth. In: Radiation, isotopes, and bone. New York, Academic;1964:61–77.
- Kleerekoper M, Peterson EL, Nelson DA, et al. A randomized trial of sodium fluoride as a treatment for postmenopausal osteoporosis. Osteoporos Int. 1991;1(3):155–161.
- Parfitt AM, Drenzer MK, Glorieux FH, et al. Bone histomorphometry: Standardization of nomenclature, symbols and unit. J Bone Mineral Res. 1987;2(6):595–611.
- Bohatyrewicz A. Effects of fluoride on bone metabolism and mechanical competence: Clinical observations and experimental studies in rats [in Polish] [habilitation thesis]. Szczecin, Poland: Pomeranian Medical University; 2002.
- Niedźwiedzki T, Pawlikowski M, Kita B. Zmiany mineralogiczne w chrząstce stawu biodrowego u osób ze zmianami zwyrodnieniowymi. Chir Narz Ruchu Ortop Pol. 1987:42:354–356.
- Glimcher MJ. The nature of mineral component of bone and the mechanism of calcification. In: Avioli LV, Krane FM. Metabolic Bone Disease and Clinically Related Disorders. 2nd ed. Philadelphia, PA: Saunders; 1990:42–56.
- Kumarasinghe DD, Perilli E, Tsangari H, et al. Critical molecular regulators, histomorphometric indices and their correlations in the trabecular bone in primary hip osteoarthritis. Osteoarthritis Cartilage. 2010;18(10):1337–1344.
- Power J, Poole KE, van Bezooijen R, et al. Sclerostin and the regulation of bone formation: Effects in hip osteoarthritis and femoral neck fracture. J Bone Miner Res. 2010;25(8):1867–1876.