Study of the intraosseous vessels of the femoral head in patients with fractures of the femoral neck or osteoarthritis of the hip

Abstract

Bearing in mind earlier studies which established a link between arteriosclerosis and mineral loss, or fragility of the bones, and also our recent study showing that patients with arterial disorders of the lower limbs also suffered from osteoporosis, we carried out a histological study of the number and appearance of the intraosseous vessels and trabecular bone volume in the femoral heads of patients undergoing surgery for either fracture of the femoral neck or osteoarthritis of the hip. The number of thick-walled vessels, arterioles or arterial capillaries was significantly diminished in the femoral heads of patients with fractures of the femoral neck (p = 0.007). In addition, in the latter patients, arteriosclerotic vascular lesions (rupture of the internal elastic lamina, medial thickening and fibrosis) were more frequent than in patients with osteoarthritis of hip. The possibility that, through chronic ischemia, arteriosclerosis may lead to disturbance of bone remodelling and loss of the mechanical properties of bone has not been contradicted by these findings.

Microvascularization of the hypermineralized calcified fibrocartilage and cortical bone in the sheep proximal femur

“…In support of our use of morphology, we note that several other investigations have utilized morphology to quantify vascular density, so our experiment was not unique in that respect (Saito et al, 1992;Arlet et al, 1993;Laroche et al, 1995). The advantage of using India ink perfusions over other techniques, such as laminin labeling, is that India ink allows observations of the 3D trajectory of blood vessels in the thicker methacrylate sections.…”

“…These pathological conditions are associated with a reduction in the number of vessels as well as an increase in the number of atherosclerotic vessels. In addition to the above pathological conditions, an investigation by Laroche et al (1995) has implicated changes in the vascular supply to the proximal femur as a factor in femoral neck fractures. These negative consequences resulting from changes in blood supply exemplify the importance of characterizing the microvascularity to the bone and calcified fibrocartilage of the proximal femur.…”

Mathematical analysis of trabecular ‘trajectories’ in apparent trajectorial structures: The unfortunate historical emphasis on the human proximal femur

“…The interpretation that the trabecular arches in this bone follow the 'lines' of tension and compression stresses is still common in contemporary literature (Bagi et al, 1997;Barbieri and Buoncristiani, 1975;Baumgaertner and Higgins, 2002;Beck et al, 1990;Berquist and Coventry, 1992;Brown and DiGioia, 1984;Bullough and Vigorita, 1984;Chapman and Zickel, 1988;Cowin, 1984;Elke et al, 1995;Fazzalari et al, 1989;Finlay et al, 1991;Fox, 2003;Ganey and Ogden, 1998;Gibson and Ashby, 1997;Greenspan, 1988;Herrera et al, 2001;Kapandji, 1987;Kawashima and Uhthoff, 1991;Kerr and Bishop, 1986;Knothe Tate, 2003;Koval and Zuckerman, 2002;Kyle, 1994;Laroche et al, 1995;Laros, 1990;Lim et al, 1999;Lotz et al, 1995;Maquet, 1985;Markolf, 1991;Martini, 1995;Miller, 1996;Miller et al, 2002;Moore, 1985;Mourtada et al, 1996;Neville, 1993;Oatis, 2004;Osborne et al, 1980;Radin et al, 1992;Resnick and Niwayama, 1988;Rosenthal and Scott, 1983;…”

Albuminuria and Rapid Loss of GFR and Risk of New Hip and Pelvic Fractures

“…Bone perfusion is perturbed in avascular necrosis and Paget's disease, and it is diminished in osteoporotic hip fracture specimens compared with those specimens from people having hip replacement surgery for arthritis (3).…”