Accumulation of microdamage in subchondral bone at the femoral head in patients with end-stage osteoarthritis of the hip

  • Masashi Shimamura
  • Ken IwataEmail author
  • Tasuku Mashiba
  • Takanori Miki
  • Tetsuji Yamamoto
Original Article


In end-stage osteoarthritis (OA) of the hip, the effect of bone metabolism with and without cartilage is unclear. In this study, we aimed to investigate histomorphology and microdamage in the subchondral bone of the femoral head in areas with and without articular cartilage in patients with end-stage OA. Nineteen femoral heads were evaluated in 10 women who underwent total hip arthroplasty for OA and in nine cadaveric controls (CNT). Chondral thickness and subchondral bone plate thickness (SBP.Th) were measured in 5-mm-wide areas where cartilage was lost (area A) or preserved (area B) in OA and in corresponding areas in the load-bearing portion of the femoral head in the CNT. Histomorphometry and microdamage in 5 × 5-mm areas of cancellous bone were assessed. SBP.Th and bone volume were significantly greater in area A than in area B or in the CNT. Osteoid volume was significantly greater in area A than in area B or in the CNT. There was no significant difference in eroded surface between area A and CNT. Microcrack density was significantly greater in area A than in area B or in the CNT. Although accumulation of microdamage was caused by concentration of stress on the subchondral bone in the cartilage loss area in end-stage OA, remodeling for microdamage repairing mechanism was not enhanced. It was considered that the subchondral cancellous bone volume was increased because of modeling, not remodeling, by stress concentration due to articular cartilage loss.


Bone microdamage Femoral head Histomorphometry Osteoarthritis Bone modeling 



The authors thank Mika Higashihara and Yoshiko Agawa for preparing the histology specimens used in this study.

Author contributions

All the authors have contributed equally to this work. MS, KI, TM, TM, and TY designed the study, contributed to the experimental work and analysis, prepared the draft of the paper, reviewed it critically for intellectual content, and approved the final version. KI is the guarantor. All the authors agree to be accountable for the work and to ensure that any questions relating to the accuracy and integrity of the paper are investigated and properly resolved.


This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


  1. 1.
    Arden NK, Griffiths GO, Hart DJ, Doyle DV, Spector TD (1996) The association between osteoarthritis and osteoporotic fracture: the Chingford study. Br J Rheumatol 35:1299–1304CrossRefGoogle Scholar
  2. 2.
    Bailey AJ, Mansell JP (1997) Do subchondral bone changes exacerbate or precede articular cartilage destruction in osteoarthritis of the elderly? Gerontology 43:296–304CrossRefGoogle Scholar
  3. 3.
    Amir G, Pirie CJ, Rashad S, Revell PA (1992) Remodelling of subchondral bone in osteoarthritis: a histomorphometric study. J Clin Pathol 45:990–992CrossRefGoogle Scholar
  4. 4.
    Grynpas MD, Alpert B, Katz I, Lieberman I, Pritzker KP (1991) Subchondral bone in osteoarthritis. Calcif Tissue Int 49:20–26CrossRefGoogle Scholar
  5. 5.
    Kumarasinghe DD, Perilli E, Tsangari H, Truong L, Kuliwaba JS, Hopwood B, Atkins GJ, Fazzalari NL (2010) Critical molecular regulators, histomorphometric indices and their correlations in the trabecular bone in primary hip osteoarthritis. Osteoarthritis Cartilage 18:1337–1344CrossRefGoogle Scholar
  6. 6.
    Bobinac D, Marinovic M, Bazdulj E, Cvijanovic O, Celic T, Maric I, Spanjol J, Cicvaric T (2013) Microstructural alterations of femoral head articular cartilage and subchondral bone in osteoarthritis and osteoporosis. Osteoarthr Cartil 21:1724–1730CrossRefGoogle Scholar
  7. 7.
    Radin EL, Rose RM (1986) Role of subchondral bone in the initiation and progression of cartilage damage. Clin Orthop Relat Res 231:34–40Google Scholar
  8. 8.
    Radin EL, Paul IL, Tolkoff MJ (1970) Subchondral bone changes in patients with early degenerative joint disease. Arthritis Rheum 13:400–405CrossRefGoogle Scholar
  9. 9.
    De Pedro JA, Martin AP, Blanco JF, Salvado M, Perez MA, Cardoso A, Collía F, Ellis SS, Domínguez J (2007) Histomorphometric study of femoral heads in hip osteoarthritis and osteoporosis. Histol Histopathol 22:1091–1097Google Scholar
  10. 10.
    Cox LG, van Donkelaar CC, van Rietbergen B, Emans PJ, Ito K (2012) Decreased bone tissue mineralization can partly explain subchondral sclerosis observed in osteoarthritis. Bone 50:1152–1161CrossRefGoogle Scholar
  11. 11.
    Li G, Ma Y, Cheng TS, Landao-Bassonga E, Qin A, Pavlos NJ, Zhang C, Zheng Q, Zheng MH (2014) Identical subchondral bone microarchitecture pattern with increased bone resorption in rheumatoid arthritis as compared to osteoarthritis. Osteoarthr Cartil 22:2083–2092CrossRefGoogle Scholar
  12. 12.
    Li G, Zheng Q, Landao-Bassonga E, Cheng TS, Pavlos NJ, Ma Y, Zhang C, Zheng MH (2015) Influence of age and gender on microarchitecture and bone remodeling in subchondral bone of the osteoarthritic femoral head. Bone 77:91–97CrossRefGoogle Scholar
  13. 13.
    Burr DB, Gallant MA (2012) Bone remodelling in osteoarthritis. Nat Rev Rheumatol 8:665–673CrossRefGoogle Scholar
  14. 14.
    Coughlin TR, Kennedy OD (2016) The role of subchondral bone damage in post-traumatic osteoarthritis. Ann NY Acad Sci 1383:58–66CrossRefGoogle Scholar
  15. 15.
    Burr DB, Radin EL (2003) Microfractures and microcracks in subchondral bone: are they relevant to osteoarthrosis? Rheum Dis Clin North Am 29:675–685CrossRefGoogle Scholar
  16. 16.
    Li ZC, Dai LY, Jiang LS, Qiu S (2012) Difference in subchondral cancellous bone between postmenopausal women with hip osteoarthritis and osteoporotic fracture: implication for fatigue microdamage, bone microarchitecture, and biomechanical properties. Arthritis Rheum 12:3955–3962CrossRefGoogle Scholar
  17. 17.
    Ramme AJ, Lendhey M, Raya JG, Kirsch T, Kennedy OD (2016) A novel rat model for subchondral microdamage in acute knee injury: a potential mechanism in post-traumatic osteoarthritis. Osteoarthr Cartil 10:1776–1785CrossRefGoogle Scholar
  18. 18.
    Kellgren JH, Lawrence JS (1957) Radiological assessment of osteo-arthrosis. Ann Rheum Dis 16:494–502CrossRefGoogle Scholar
  19. 19.
    Burr DB, Stafford T (1990) Validity of the bulk-staining technique to separate artifactual from in vivo bone microdamage. Clin Orthop Rel Res 260:305–308Google Scholar
  20. 20.
    Kuliwaba JS, Findlay DM, Atkins GJ, Forwood MR, Fazzalari NL (2000) Enhanced expression of osteocalcin mRNA in human osteoarthritic trabecular bone of the proximal femur is associated with decreased expression of interleukin-6 and interleukin-11 mRNA. J Bone Miner Res 15:332–341CrossRefGoogle Scholar
  21. 21.
    Dempster DW (2006) Anatomy and functions on the adults skeleton. In: Favus MJ (ed) Primer on the metabolic bone diseases and disorder of mineral metabolism, 6th edn. American Society for Bone and Mineral Research, Washington, pp 7–11Google Scholar
  22. 22.
    Burr DB (1997) Bone microdamage and skeletal fragility in osteoporotic and stress fractures. J Bone Miner Res 12:6–15CrossRefGoogle Scholar
  23. 23.
    Mori S, Burr DB (1993) Increased intracortical remodeling following fatigue damage. Bone 14:103–109CrossRefGoogle Scholar
  24. 24.
    Li J, Mashiba T, Burr DB (2001) Bisphosphonate treatment suppresses not only stochastic remodeling but also the targeted repair of microdamage. Calcif Tissue Int 69:281–286CrossRefGoogle Scholar
  25. 25.
    Frost HM (1986) Bone microdamage: Factors that impair its repair. In: Uhthoff HK (ed) Current concepts of bone fragility. Springer, BerlinGoogle Scholar
  26. 26.
    Felton DT (2013) Osteoarthritis as a disease of mechanics. Osteoarthr Cartil 21:10–15CrossRefGoogle Scholar

Copyright information

© Springer Japan KK, part of Springer Nature 2019

Authors and Affiliations

  • Masashi Shimamura
    • 1
  • Ken Iwata
    • 1
    Email author
  • Tasuku Mashiba
    • 1
  • Takanori Miki
    • 2
  • Tetsuji Yamamoto
    • 1
  1. 1.Department of Orthopaedic Surgery, Faculty of MedicineKagawa UniversityKita-gunJapan
  2. 2.Department of Anatomy and Neurobiology, Faculty of MedicineKagawa UniversityKita-gunJapan

Personalised recommendations