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Influence of Factors Regulating Bone Formation and Remodeling on Bone Quality in Osteonecrosis of the Femoral Head

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Abstract

Osteonecrosis of the femoral head (ONFH) usually affects young individuals and has a major impact on lifestyle. Notably, the pathogenetic mechanisms of osteonecrosis are unresolved and no effective treatment exists. The objective of this study was to assess the gene expression levels of factors regulating bone formation and remodeling (bone morphogenetic protein [BMP]-2, BMP-7, Runx2, osteocalcin, osteoprotegerin [OPG]) in patients with ONFH and to compare them to those of patients with primary osteoarthritis (OA). The cellular and macromolecular composition of the bone matrix was assessed by osteocalcin immunohistochemistry, and the three-dimensional organization of trabecular bone was characterized by micro-computed tomographic analysis. Our results demonstrate that gene expression of BMP-2, BMP-7, and Runx2 is elevated in patients with ONFH. We observed increased extracellular osteocalcin deposition, presumably caused by a higher number of osteoblasts in concordance with increased activity of Runx2. Constant gene expression level of OPG implies an unchanged osteoclast differentiation rate in ONFH bone. We found no significant change in bone volume, connectivity, and structural model index; further, no significant differences were detected for trabecular properties in ONFH bone. In conclusion, we have shown increased gene expression of factors regulating bone formation and remodeling in the femoral head and/or neck of patients with ONFH. Further, we observed an increase in osteocalcin immunoreactivity and osteoblast/osteocyte cell number, while no significant changes in trabecular microarchitecture were detected. This study increases our understanding of the pathophysiology and repair process following ONFH and might help in the development of new treatment strategies in the future.

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Acknowledgements

We appreciate the financial support of the Deutsche Forschungsgemeinschaft for this study, assigned to M. T. and S. G. (Az: TI 305/2-1). We also thank Claudia Göttl and Mandy Vogel for their superior technical support.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, University of Regensburg, Kaiser-Karl V-Allee 3, 93077, Bad Abbach, Germany

    Markus Tingart, Johannes Beckmann, Oliver Wiech & Joachim Grifka

  2. Department of Orthopedic Surgery, University of Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany

    Alfred Opolka

  3. Institute of Anatomy, Ludwig-Maximilian-University, Munich, Germany

    Maiko Matsuura

  4. Department of Orthopedic Surgery, University of Regensburg, ZMB/BioPark, Josef-Engert-Str. 9, 93053, Regensburg, Germany

    Susanne Grässel

  5. Centre for Medical Biotechnology, BioPark I, Regensburg, Germany

    Susanne Grässel

Authors
  1. Markus Tingart
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  2. Johannes Beckmann
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  3. Alfred Opolka
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  4. Maiko Matsuura
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  5. Oliver Wiech
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  6. Joachim Grifka
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  7. Susanne Grässel
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Corresponding author

Correspondence to Susanne Grässel.

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Tingart, M., Beckmann, J., Opolka, A. et al. Influence of Factors Regulating Bone Formation and Remodeling on Bone Quality in Osteonecrosis of the Femoral Head . Calcif Tissue Int 82, 300–308 (2008). https://doi.org/10.1007/s00223-008-9111-z

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  • DOI: https://doi.org/10.1007/s00223-008-9111-z

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