Changes in bone architecture in the femoral head and neck in osteoarthritis

This study analyses changes in the bony architecture of the femoral head and neck in osteoarthritis. Five osteoarthritic hips were obtained from female patients undergoing total hip replacement and were compared to non-arthritic control specimens from the dissecting room. Analysis was carried out on a coronal bony slice of the femoral head and on a transverse section of the upper femoral neck. The results indicated that in the region of the compressive trabeculae the intertrabecular areas were generally smaller in the osteoarthritic specimens and that the inferior part of the cortex of the femoral neck had thickened. Our data thus quantified changes consistent with the thickening of compressive trabeculae reported by others and with thickening of the region of the femoral neck on which they converge. We found less trabecular bone in non-weight-bearing regions of the lower femoral head and in the medulla of the upper neck in the osteoarthritic specimens consistent with loss of tensile trabeculae. Scanning electron microscopy suggested that bone resorption activity was higher in the subchondral and non-weight-bearing regions of the osteoarthritic femoral heads than in the controls.