| Objective The aim of this study was to investigate the regional trabecular microarchitecture heterogeneity of femoral head in osteoporosis fracture with gender and find out the corresponding association between trabecular microarchitecture and fractures.Methods Human femoral heads were obtained from 10 male (M) (average age 64.70±9.44 years old, ranged from 52 to 82 years old) and 12 female (F) osteoporotic fracture patients (average age 74.51±11.84 years old, ranged from 51 to 99 years old) who underwent total hip arthroplasty in two hours for each gender group. After laying femoral head as living body position and locating primary loading region as the mark, nine trabecular specimens, each of 6×6×7mm3, were obtained from which were orientated along the vertical plane of the primary compressive in the maximum diameter of femoral heads. The cortical shell was not included in each specimen. Sample No.5 was defined as the central region and the remains as peripheral region. These cubes were scanned using high-resolution microcomputed tomography scanner (μCT), then the regional variation of different gender were analyses on the mean values of trabecular microstructure between female and male group, peripheral region and central region of different gender.Result There was a significant decreased in bone surface fraction (13.25±2.56 VS 14.16±2.55 mm-1),connectivity density (2.40±2.3 VS 3.16±1.88 mm-3)and increased in trabecular thickness (173.47±47.08 VS 157.79±45.52μm), female group vs male group, respectively. Compared peripheral region and central region, there was a significant increased in bone surface fraction (13.42±2.55 VS 11.79±2.22 mm-1), degree of anisotropy (1.5804±0.1992 VS 1.4510±0.1577) and a significant decreased in trabecular thickness (169.46±44.81 VS 205.55±54.41μm), bone mineral density (187.99±66.29 VS 231.63±77.38 mg/mm3), bone mineral content (15.16±5.34 VS 18.69±6.24 mg), bone volume fraction (0.22±0.05 VS 0.26±0.07%) in female group respectively. But no significant differences were found in male osteoporosis fracture. There was also a significant decreased in bone surface fraction(13.42±2.55 VS 14.25±2.51 mm-1), connectivity density(2.39±2.44 VS 3.11±1.85 mm-3) and a significant increased in trabecular thickness (169.46±44.81 VS 153.81±40.11 mm-1) in peripheral region between group female and male group, respectively. No significant difference was found in central region in female and male group. Regional variations in trabecular microarchitecture of femoral head in female osteoporotic fracture indicated that peripheral region deterioated much worse than the central region, the microarchitecture reserved much better in the central region. But no much significances were not reached for the trabecular microstructure in male osteoporotic fracture. Conclusion Gender-related changes in trabecular microarchitecture varied from different regions of femoral head in the experimental plane. There was a significant difference between peripheral and central region of femoral head in female osteoporosis fracture, the central region reserved more trabecular microarchitecture. However, the trabecular microarchitecture of femoral head in male osteoporosis fracture deterioated relative homogenously. Gender-related regional variation in trabecular microarchitecture might be the micro-level fundament of inconsistant incidence of osteoporosis fracture in different gender.
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