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Analysis of Trabecular Microstructure and Vascular Distribution of Capital Femoral Epiphysis Relevant to Legg-Calve-Perthes Disease.
- Source :
-
Journal of orthopaedic research : official publication of the Orthopaedic Research Society [J Orthop Res] 2019 Aug; Vol. 37 (8), pp. 1784-1789. Date of Electronic Publication: 2019 Apr 25. - Publication Year :
- 2019
-
Abstract
- Legg-Calve-Perthes disease is characterized by the capital femoral epiphyseal collapse, which occurs more reliably in the anterior quadrant than the more weight-bearing lateral quadrant. The purpose of this study was to determine whether there is a vascular or microstructural predisposition for anterior femoral epiphyseal collapse in Perthes disease. Thirty-two cadaveric proximal femoral epiphyses from 17 subjects (age 4-14 years old) underwent micro-computed tomography at 10-μm resolution. Each quadrant was analyzed for four markers of trabecular architecture: bone volume fraction (BV/TV), trabecular thickness, trabecular separation (TbSp), and trabecular number (TbN). Vascular channels were then mapped in each quadrant, identified by correlating surface topography with cross-sectional imaging. One-way analysis of variance revealed an overall difference between quadrants (p < 0.001) in BV/TV, TbN, and TbSp. However, post hoc analysis revealed there was no significant difference between the anterior and lateral quadrants for any of the four markers of trabecular architecture. Vascular channel mapping illustrated a predominance of vessels in the posterior half of the epiphysis compared to the anterior half (8.7 ± 4.0 vs. 3.4 ± 3.1 vascular channels, p < 0.001). The lack of microstructural differences between the anterior and lateral quadrants, and the predominance of vascular channels in the posterior half of the epiphysis with posteriorly-based medial femoral circumflex and ligamentum teres vessels suggests that the anterior femoral epiphysis may be a relative vascular watershed region, which predisposes it to collapse after the vascular insult of Perthes disease. Clinical significance: Improved understanding of the pathophysiology of anterior femoral epiphyseal collapse may inform future treatments aimed at revascularization. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 37:1784-1789, 2019.<br /> (© 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.)
- Subjects :
- Adolescent
Cancellous Bone blood supply
Cancellous Bone diagnostic imaging
Child
Child, Preschool
Epiphyses blood supply
Epiphyses diagnostic imaging
Epiphyses pathology
Female
Femur blood supply
Femur diagnostic imaging
Humans
Legg-Calve-Perthes Disease diagnostic imaging
Male
X-Ray Microtomography
Cancellous Bone pathology
Femur pathology
Legg-Calve-Perthes Disease pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1554-527X
- Volume :
- 37
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Journal of orthopaedic research : official publication of the Orthopaedic Research Society
- Publication Type :
- Academic Journal
- Accession number :
- 30977552
- Full Text :
- https://doi.org/10.1002/jor.24311