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Osteoclast‐related markers in the hip joint fluid with subchondral insufficiency fracture of the femoral head
Author(s) -
Kubo Yusuke,
Motomura Goro,
Ikemura Satoshi,
Hatanaka Hiroyuki,
Fukushi Junichi,
Hamai Satoshi,
Yamamoto Takuaki,
Nakashima Yasuharu
Publication year - 2018
Publication title -
journal of orthopaedic research®
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.041
H-Index - 155
eISSN - 1554-527X
pISSN - 0736-0266
DOI - 10.1002/jor.24066
Subject(s) - femoral head , osteoclast , medicine , coronal plane , avascular necrosis , progressive collapse , insufficiency fracture , nuclear medicine , anatomy , materials science , osteoporosis , receptor , reinforced concrete , composite material
ABSTRACT Similar to the radiological findings in rapidly destructive arthrosis of the hip joint (RDA), subchondral insufficiency fracture of the femoral head (SIF) can result in progressive femoral head collapse of unknown etiology. We thus examined the osteoclast activity of hip joint fluid in SIF with progressive collapse in comparison with that in RDA. Twenty‐nine hip joint fluid samples were obtained intraoperatively with whole femoral heads from 12 SIF patients and 17 RDA patients. SIF cases were classified into subgroups based on the presence of ≥2 mm collapse on preoperative radiographs: SIF with progressive collapse ( n = 5) and SIF without progressive collapse ( n = 7). The levels of tartrate‐resistant acid phosphatase (TRACP)‐5b, interleukin‐8, vascular endothelial growth factor (VEGF), and matrix metalloproteinase (MMP)‐9 were measured. The number of multinuclear giant cells at the subchondral region was histopathologically assessed using mid‐coronal slice of each femoral head specimen. The median levels of all markers and the median number of multinuclear giant cells in SIF with progressive collapse were significantly higher than those in SIF without progressive collapse, while there were no significant differences in SIF with progressive collapse versus RDA. Regression analysis showed that the number of multinuclear giant cells was positively correlated with the level of TRACP‐5b in joint fluid. The present study demonstrated the possible association of increased osteoclast activity with the existing condition of progressive collapse in SIF, which was quite similar to the findings in RDA, indicating that increased osteoclast activity may reflect the condition of progressive collapse in SIF as well as RDA. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:2987–2995, 2018.