Calcification of the acetabular labrum of the hip: prevalence in the general population and relation to hip articular cartilage and fibrocartilage degeneration

Springer Science and Business Media LLC - Tập 20 - Trang 1-10 - 2018
Thelonius Hawellek1, Jan Hubert1, Sandra Hischke2, Matthias Krause3, Jessica Bertrand4, Burkhard C. Schmidt5, Andreas Kronz5, Klaus Püschel6, Wolfgang Rüther1, Andreas Niemeier1
1Department of Orthopaedics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
2Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
3Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
4Department of Orthopaedic Surgery, Otto-von-Guerricke-University Magdeburg, Magdeburg, Germany
5Centrum of Geoscience, Georg-August-University Göttingen, Göttingen, Germany
6Department of Legal Medicine, University Medical Center Hamburg–Eppendorf, Hamburg, Germany

Tóm tắt

Meniscal calcification is considered to play a relevant role in the pathogenesis of osteoarthritis of the knee. Little is known about the biology of acetabular labral disease and its importance in hip pathology. Here, we analyze for the first time the calcification of the acetabular labrum of the hip (ALH) and its relation to hip cartilage degeneration. In this cross-sectional post-mortem study of an unselected sample of the general population, 170 ALH specimens and 170 femoral heads from 85 donors (38 female, 47 male; mean age 62.1 years) were analyzed by high-resolution digital contact radiography (DCR) and histological degeneration grade. The medial menisci (MM) from the same 85 donors served as an intra-individual reference for cartilage calcification (CC). Scanning electron microscopy (SEM), energy dispersive analysis (ED) and Raman spectroscopy were performed for characterization of ALH CC. The prevalence of CC in the ALH was 100% and that in the articular cartilage of the hip (ACH) was 96.5%. Quantitative analysis revealed that the amount of ALH CC was higher than that in the ACH (factor 3.0, p < 0.001) and in the MM (factor 1.3, p < 0.001). There was significant correlation between the amount of CC in the fibrocartilage of the left and right ALH (r = 0.70, p < 0.001). Independent of age, the amount of ALH CC correlated with histological degeneration of the ALH (Krenn score) (r = 0.55; p < 0.001) and the ACH (Osteoarthritis Research Society International (OARSI), r = 0.69; p < 0.001). Calcification of the ALH was characterized as calcium pyrophosphate dihydrate deposition. The finding that ALH fibrocartilage is a strongly calcifying tissue is unexpected and novel. The fact that ALH calcification correlates with cartilage degeneration independent of age is suggestive of an important role of ALH calcification in osteoarthritis of the hip and renders it a potential target for the prevention and treatment of hip joint degeneration.

Tài liệu tham khảo

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