Different subchondral trabecular bone microstructure and biomechanical properties between developmental dysplasia of the hip and primary osteoarthritis

Linyang Chu; Zihao He; Xinhua Qu; Xuqiang Liu; Weituo Zhang; Shuo Zhang; Xuequan Han; Mengning Yan; Qi Xu; Shuhong Zhang; Xifu Shang; Zhifeng Yu

doi:10.1016/j.jot.2019.09.001

Different subchondral trabecular bone microstructure and biomechanical properties between developmental dysplasia of the hip and primary osteoarthritis

J Orthop Translat. 2019 Sep 27:22:50-57. doi: 10.1016/j.jot.2019.09.001. eCollection 2020 May.

Authors

Linyang Chu¹, Zihao He¹, Xinhua Qu², Xuqiang Liu³, Weituo Zhang⁴, Shuo Zhang⁴, Xuequan Han¹, Mengning Yan¹, Qi Xu¹, Shuhong Zhang¹, Xifu Shang⁵, Zhifeng Yu¹

Affiliations

¹ Shanghai Key Laboratory of Orthopedic Implants, Department of Orthopedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China.
² Department of Bone and Joint Surgery, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200011, PR China.
³ Department of Orthopedics, The First Affiliated Hospital of Nanchang University, The Artificial Joint Engineering and Technology Research Center of Jiangxi Province, Nanchang, PR China.
⁴ Clinical Research Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, PR China.
⁵ Department of Orthopedics, The Affiliated Provincial Hospital of China Science and Technology University, Hefei, 230001, Anhui Province, PR China.

Abstract

Objective: Developmental dysplasia of the hip (DDH) is recognized as a frequent cause of secondary osteoarthritis (OA). The purpose in this study was to compare structural and biomechanical properties of subchondral trabecular bone and its relationship with cartilage damage between patients with DDH and patients with primary hip OA.

Methods: Forty-three femoral head specimens obtained from patients who underwent total hip arthroplasty [DDH, n = 17; primary OA, n = 16; and normal control (NC), n = 10] were scanned by microcomputed tomography and analyzed by individual trabecula segmentation to obtain the microstructural types of subchondral trabecular bone. The biomechanical properties were analyzed by micro-finite element analysis, and cartilage damage was evaluated by histology. The linear regression analysis was used to indicate the association between microstructures, biomechanical property, and articular cartilage.

Results: The DDH group showed the lowest total bone volume fractions (BV/TV) and plate BV/TV in the three groups (p < 0.05). There were also different discrepancies between the three groups in plate/rod trabecular number, plate/rod trabecular thickness, trabecular plate surface area/trabecular rod length, and junction density with different modes (plate-plate, rod-rod, and plate-rod junction density). The micro-finite element analysis, histology, and linear regression revealed that the subchondral trabecular bone in the DDH group had inferior biomechanical properties and cartilage damage of patients with DDH was more serious with different subchondral trabecular bone microstructures.

Conclusion: Our findings detected deteriorating subchondral trabecular bone microstructures in patients with DDH. The mass and type of subchondral trabecular bone play a key role in mechanical properties in DDH, which might be related to cartilage damage.

The translational potential of this article: Our findings suggested that changes of subchondral trabecular bone play a critical role in DDH progression and that the improvement on subchondral trabecular bone may be a sensitive and promising way in treatment of DDH.

Keywords: Biomechanical properties; Cartilage damage; DDH; Individual trabecula segmentation; Subchondral trabecular bone.