Examination of proximal femur bone in unilateral end-stage hip osteoarthritis using fractal analysis

Osteoarthritis (OA) is the most common joint disorder and the microstructural changes in trabecular bone remain unclear. The present study aimed to evaluate the fractal dimensions of the trabecular bone structure of the femoral neck on pelvic radiograph images of patients with unilateral end-stage hip OA. The trabecular structures of the femoral neck of 130 patients (57 with right-sided hip joint OA and 73 with left-sided hip joint OA) were evaluated and compared with the Fractal Analysis Method, taking into account gender and hip joint orientation. The fractal dimension calculated from the femoral neck on the right and left sides was similar to the healthy side in individuals with OA (p=0.647, p=0.929, respectively). When OA and healthy joints were compared separately on the right and left sides, the value on the osteoarthritic side was found to be significantly lower (p<0.05). When examined without distinguishing between the right and left sides, the fractal dimensions were found to be significantly lower in osteoarthritic joints than in the healthy side (p=0.001). When gender was taken into account, the fractal dimension calculated in both healthy individuals and individuals with OA was found to be similar in women and men (p>0.05). The fractal dimensions of the femoral neck trabecular structure of the osteoarthritic hip joint that was evaluated in pelvis radiography were low on the osteoarthritic side. With its cost-free and harmless use, the Fractal Analysis Method can be used by clinicians in planning therapeutic procedures in OA in the medical examination of OA patients.