Objective To study the microstructural parameters of the proximal femur in elderly individuals, providing reference for the design of artificial femoral heads and improvement of hip replacement in clinical practice. Method Thirty femoral specimens from the anatomy laboratory of Inner Mongolia Medical University were collected for teaching purposes (normal group). The specimens were aged 60-80 years old (with an average of 68 years) without a history of pelvic or femoral surgery. Additionally, nine femoral heads from patients who underwent CT scans at the Second Affiliated Hospital of Inner Mongolia Medical University in 2023 were selected as cases of femoral head necrosis (necrosis group), including 3 specimens in ARCO stage III and 6 specimens in ARCO stage IV. Micro-CT scanning was performed, and three-dimensional reconstruction of the femoral head was carried out using Reconstruct software for measurement of the three-column structure of the femoral head (based on the CJFH classification proposed by the Sino-Japanese Friendship Hospital, dividing the femoral head into lateral column, central column, and medial column, with lateral column accounting for 30%, central column for 40%, and medial column for 30%). The differences in the microstructure of bone quality in different regions were analyzed by measuring eight parameters including total volume, bone volume, bone surface density, trabecular thickness, spacing, number, connectivity, and volume fraction. Results There was no statistically significant difference in the connectivity between the three columns in the normal group. However, there were statistically significant differences in parameters such as total volume, bone volume, bone density, trabecular separation, trabecular thickness, trabecular number, and volume fraction of bone (P<0.05). Specifically, the total volume was greater in the middle and outer columns compared to the inner column. Bone volume and bone surface density were greater in the middle column compared to the inner and outer columns (P<0.05). Trabecular thickness was lower in the middle column compared to the inner and outer columns (P<0.05). Volume fraction and trabecular number were lower in the outer column compared to the middle and inner columns; and trabecular separation was greater in the outer column compared to the middle and inner columns (P<0.05). The overall volume, bone volume, and volume fraction of the medial pillar in the ARCO stage III necrotic group were all higher than those in the normal group (P<0.05). While the connectivity in the ARCO stage III necrotic group was lower than that in the normal group. In the ARCO Ⅳ stage necrotic group, the trabecular thickness and spacing in the central pillar are greater than those in the normal group. Bone surface density, trabecular number, and connectivity are lower than those in the normal group. The total volume, bone volume, and trabecular thickness in the medial pillar are greater than those in the normal group. Bone surface density and trabecular number are lower than those in the normal group. Conclusion There are differences in the three-column structure of the femoral head in the normal group, except for connectivity. There are differences in bone microstructure parameters between the necrotic group and the normal group in the three-column structure of the femoral head.
Key words
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Femoral head /
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Bone microstructure /
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Micro-CT /
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Digital measurement /
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Elderly
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