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Predictors of cartilage degeneration in patients with subchondral insufficiency fracture of the femoral head : a retrospective study

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Title: Predictors of cartilage degeneration in patients with subchondral insufficiency fracture of the femoral head : a retrospective study
Authors: Shimizu, Tomohiro Browse this author →KAKEN DB
Yokota, Shunichi Browse this author
Kimura, Yosuke Browse this author
Asano, Tsuyoshi Browse this author →KAKEN DB
Shimizu, Hirokazu Browse this author
Ishizu, Hotaka Browse this author
Iwasaki, Norimasa Browse this author →KAKEN DB
Takahashi, Daisuke Browse this author →KAKEN DB
Keywords: Subchondral insufficient fracture
Joint space narrowing
Hip joint
Bone metabolic marker
Issue Date: 22-Jun-2020
Publisher: BioMed Central
Journal Title: Arthritis research & therapy
Volume: 22
Issue: 1
Publisher DOI: 10.1186/s13075-020-02243-7
Abstract: BackgroundThere is evidence that the cause of primary osteoarthritis (OA) is related to the changes in subchondral bone; however, the influence of subchondral insufficiency fracture (SIF) of the femoral head on the degeneration of the hip joint and the prognostic factors related to joint degeneration remain unclear. The objectives of this study were (1) to investigate the natural history of joint space width after the occurrence of SIF and (2) to investigate the associations between joint space narrowing and bone metabolic markers as well as magnetic resonance imaging (MRI) among the patients with SIF.MethodsBetween January 2010 and December 2019, 238 patients in whom band pattern of the femoral head were observed on MRI visited Hokkaido University Hospital. Among these patients, 44 hips in 41 patients were diagnosed with SIF and eligible for this retrospective study. We evaluated the joint space width (JSW) of the hip on the radiograph obtained at the first and last visits, length of the band lesion on MRI, bone mineral density by dual-energy X-ray absorptiometry, and bone metabolism markers. Similarly, the factors associated with the necessity of surgery and the progression of the narrowing of the joint space were evaluated.ResultsFifteen of the 44 hips required total hip arthroplasty (THA). A significant decrease was observed in the JSW from the first visit to the final follow-up. Changes in the JSW were associated with the length of band patterns, serum type 1 procollagen-N-propeptide (P1NP), and tartrate-resistant acid phosphatase 5b (TRACP-5b) during diagnosis. Additionally, bone metabolic markers tended to be associated with the length of the band pattern.ConclusionsSIF could cause joint space narrowing and hip OA. In addition to MRI findings as prognostic predictors of SIF, as previously described, bone metabolic markers were equally associated with changes in JSW, suggesting that these parameters could be useful in predicting the prognosis of SIF. Considering that bone metabolic markers trended to be associated with the length of band pattern, they might reflect the local severity.
Type: article
Appears in Collections:国際連携研究教育局 : GI-CoRE (Global Institution for Collaborative Research and Education : GI-CoRE) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)
医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

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