Bone microarchitecture of the talus changes with aging
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Bone microarchitecture of the talus changes with aging. / Krause, Matthias; Rupprecht, Martin; Mumme, Marcus; Püschel, Klaus; Amling, Michael; Barvencik, Florian.
in: CLIN ORTHOP RELAT R, Jahrgang 471, Nr. 11, 01.11.2013, S. 3663-71.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Bone microarchitecture of the talus changes with aging
AU - Krause, Matthias
AU - Rupprecht, Martin
AU - Mumme, Marcus
AU - Püschel, Klaus
AU - Amling, Michael
AU - Barvencik, Florian
PY - 2013/11/1
Y1 - 2013/11/1
N2 - BACKGROUND: Fractures of the talus in the elderly are rare and usually result from high-impact injuries, suggesting only minor age-related bone structure changes. However, total ankle replacement failures with age often result from talar subsidence, suggesting age-related bone loss in the talus. Despite a number of histological analyses of talar microarchitecture, the effects of age and sex on talar microarchitecture changes remain poorly defined.QUESTIONS/PURPOSES: The aim of this study was to analyze changes or differences in the trabecular microarchitecture of the talus with regard to (1) age and (2) sex.METHODS: Sixty human tali were harvested from 30 patients at autopsy of three different age groups (20-40, 41-60, 61-80 years). The specimens were analyzed by radiography, micro-CT, and histological analysis. Given that there was no difference between the left and right talus, static histomorphometric parameters were assessed in three regions of interest of the right talus only (body, neck, head; n = 30).RESULTS: The talar body, neck, and head were affected differently by age-related changes. The greatest loss of bone volume with age was seen in the talar body (estimate: -0.239; 95% confidence interval [CI], -0.365 to -0.114; p < 0.001). In the talar neck (estimate: -0.165; 95% CI, -0.307 to -0.023; p = 0.025), bone loss was only moderate and primarily was the result of reduction in trabecular thickness (estimate: -1.288; 95% CI, -2.449 to -0.127; p = 0.031) instead of number (estimate: -0.001; 95% CI, -0.005 to -0.003; p = 0.593). Bone structure changes were independent of sex.CONCLUSIONS: Age-related bone structure changes predominantly occur in the talar body, which poses a potential risk factor for total ankle replacement loosening. The moderate changes in the talar neck might explain the persistent low incidence of talar neck fractures with age.CLINICAL RELEVANCE: Our findings suggest that before total ankle replacement implantation, careful patient selection with dual-energy xray absorptiometry evaluation may be necessary to reduce the risk of talar implant subsidence.
AB - BACKGROUND: Fractures of the talus in the elderly are rare and usually result from high-impact injuries, suggesting only minor age-related bone structure changes. However, total ankle replacement failures with age often result from talar subsidence, suggesting age-related bone loss in the talus. Despite a number of histological analyses of talar microarchitecture, the effects of age and sex on talar microarchitecture changes remain poorly defined.QUESTIONS/PURPOSES: The aim of this study was to analyze changes or differences in the trabecular microarchitecture of the talus with regard to (1) age and (2) sex.METHODS: Sixty human tali were harvested from 30 patients at autopsy of three different age groups (20-40, 41-60, 61-80 years). The specimens were analyzed by radiography, micro-CT, and histological analysis. Given that there was no difference between the left and right talus, static histomorphometric parameters were assessed in three regions of interest of the right talus only (body, neck, head; n = 30).RESULTS: The talar body, neck, and head were affected differently by age-related changes. The greatest loss of bone volume with age was seen in the talar body (estimate: -0.239; 95% confidence interval [CI], -0.365 to -0.114; p < 0.001). In the talar neck (estimate: -0.165; 95% CI, -0.307 to -0.023; p = 0.025), bone loss was only moderate and primarily was the result of reduction in trabecular thickness (estimate: -1.288; 95% CI, -2.449 to -0.127; p = 0.031) instead of number (estimate: -0.001; 95% CI, -0.005 to -0.003; p = 0.593). Bone structure changes were independent of sex.CONCLUSIONS: Age-related bone structure changes predominantly occur in the talar body, which poses a potential risk factor for total ankle replacement loosening. The moderate changes in the talar neck might explain the persistent low incidence of talar neck fractures with age.CLINICAL RELEVANCE: Our findings suggest that before total ankle replacement implantation, careful patient selection with dual-energy xray absorptiometry evaluation may be necessary to reduce the risk of talar implant subsidence.
KW - Adult
KW - Age Factors
KW - Aged
KW - Aged, 80 and over
KW - Aging
KW - Autopsy
KW - Bone Remodeling
KW - Female
KW - Humans
KW - Male
KW - Middle Aged
KW - Osteoporosis
KW - Sex Factors
KW - Talus
KW - X-Ray Microtomography
KW - Young Adult
U2 - 10.1007/s11999-013-3195-0
DO - 10.1007/s11999-013-3195-0
M3 - SCORING: Journal article
C2 - 23893363
VL - 471
SP - 3663
EP - 3671
JO - CLIN ORTHOP RELAT R
JF - CLIN ORTHOP RELAT R
SN - 0009-921X
IS - 11
ER -