Formation Dominates Resorption With Increasing Mineralized Density and Time Postfracture in Cortical but Not Trabecular Bone: A Longitudinal HRpQCT Imaging Study in the Distal Radius
ABSTRACT Clinical evaluation of fracture healing is often limited to an assessment of fracture bridging from radiographic images, without consideration for other aspects of bone quality. However, recent advances in HRpQCT offer methods to accurately monitor microstructural bone remodeling throughout...
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doaj-3227c2e10120442ebe3b2ebf4a4af1b32021-06-21T13:47:59ZengWileyJBMR Plus2473-40392021-06-0156n/an/a10.1002/jbm4.10493Formation Dominates Resorption With Increasing Mineralized Density and Time Postfracture in Cortical but Not Trabecular Bone: A Longitudinal HRpQCT Imaging Study in the Distal RadiusPenny R Atkins0Kerstin Stock1Nicholas Ohs2Caitlyn J Collins3Lukas Horling4Stefan Benedikt5Gerald Degenhart6Kurt Lippuner7Michael Blauth8Patrik Christen9Ralph Müller10Institute for Biomechanics, ETH Zurich Zurich SwitzerlandDepartment of Orthopedics and Trauma Surgery Medical University of Innsbruck Innsbruck AustriaInstitute for Biomechanics, ETH Zurich Zurich SwitzerlandInstitute for Biomechanics, ETH Zurich Zurich SwitzerlandDepartment of Orthopedics and Trauma Surgery Medical University of Innsbruck Innsbruck AustriaDepartment of Orthopedics and Trauma Surgery Medical University of Innsbruck Innsbruck AustriaDepartment of Radiology Medical University Innsbruck Innsbruck AustriaDepartment of Osteoporosis Bern University Hospital, University of Bern Bern SwitzerlandDepartment of Orthopedics and Trauma Surgery Medical University of Innsbruck Innsbruck AustriaInstitute for Biomechanics, ETH Zurich Zurich SwitzerlandInstitute for Biomechanics, ETH Zurich Zurich SwitzerlandABSTRACT Clinical evaluation of fracture healing is often limited to an assessment of fracture bridging from radiographic images, without consideration for other aspects of bone quality. However, recent advances in HRpQCT offer methods to accurately monitor microstructural bone remodeling throughout the healing process. In this study, local bone formation and resorption were investigated during the first year post fracture in both the fractured (n = 22) and contralateral (n = 19) radii of 34 conservatively treated patients (24 female, 10 male) who presented with a unilateral radius fracture at the Innsbruck University Hospital, Austria. HRpQCT images and clinical metrics were acquired at six time points for each patient. The standard HRpQCT image acquisition was captured for all radii, with additional distal and proximal image acquisitions for the fractured radii. Measured radial bone densities were isolated with a voxel‐based mask and images were rigidly registered to images from the previous imaging session using a pyramid‐based approach. From the registered images, bone formation and resorption volume fractions were quantified for multiple density‐based thresholds and compared between the fractured and contralateral radius and relative to demographics, bone morphometrics, and fracture metrics using regression. Compared with the contralateral radius, both bone formation and resorption were significantly increased in the fractured radius throughout the study for nearly all evaluated thresholds. Higher density cortical bone formation continually increased throughout the duration of the study and was significantly greater than resorption during late‐stage healing in both the fractured and intact regions of the radius. With the small and diverse study population, only weak relationships between fracture remodeling and patient‐specific parameters were unveiled. However this study provides methods for the analysis of local bone remodeling during fracture healing and highlights relevant considerations for future studies, specifically that remodeling postfracture is likely to continue beyond 12‐months postfracture. © 2021 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.https://doi.org/10.1002/jbm4.10493ANALYSIS/QUANTITATION OF BONEBONE QUANTITATIVE COMPUTED TOMOGRAPHY (QCT)BONE MICRO‐COMPUTED TOMOGRAPHY (μCT)INJURY/FRACTURE HEALINGORTHOPAEDICSRADIOLOGY |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Penny R Atkins Kerstin Stock Nicholas Ohs Caitlyn J Collins Lukas Horling Stefan Benedikt Gerald Degenhart Kurt Lippuner Michael Blauth Patrik Christen Ralph Müller |
spellingShingle |
Penny R Atkins Kerstin Stock Nicholas Ohs Caitlyn J Collins Lukas Horling Stefan Benedikt Gerald Degenhart Kurt Lippuner Michael Blauth Patrik Christen Ralph Müller Formation Dominates Resorption With Increasing Mineralized Density and Time Postfracture in Cortical but Not Trabecular Bone: A Longitudinal HRpQCT Imaging Study in the Distal Radius JBMR Plus ANALYSIS/QUANTITATION OF BONE BONE QUANTITATIVE COMPUTED TOMOGRAPHY (QCT) BONE MICRO‐COMPUTED TOMOGRAPHY (μCT) INJURY/FRACTURE HEALING ORTHOPAEDICS RADIOLOGY |
author_facet |
Penny R Atkins Kerstin Stock Nicholas Ohs Caitlyn J Collins Lukas Horling Stefan Benedikt Gerald Degenhart Kurt Lippuner Michael Blauth Patrik Christen Ralph Müller |
author_sort |
Penny R Atkins |
title |
Formation Dominates Resorption With Increasing Mineralized Density and Time Postfracture in Cortical but Not Trabecular Bone: A Longitudinal HRpQCT Imaging Study in the Distal Radius |
title_short |
Formation Dominates Resorption With Increasing Mineralized Density and Time Postfracture in Cortical but Not Trabecular Bone: A Longitudinal HRpQCT Imaging Study in the Distal Radius |
title_full |
Formation Dominates Resorption With Increasing Mineralized Density and Time Postfracture in Cortical but Not Trabecular Bone: A Longitudinal HRpQCT Imaging Study in the Distal Radius |
title_fullStr |
Formation Dominates Resorption With Increasing Mineralized Density and Time Postfracture in Cortical but Not Trabecular Bone: A Longitudinal HRpQCT Imaging Study in the Distal Radius |
title_full_unstemmed |
Formation Dominates Resorption With Increasing Mineralized Density and Time Postfracture in Cortical but Not Trabecular Bone: A Longitudinal HRpQCT Imaging Study in the Distal Radius |
title_sort |
formation dominates resorption with increasing mineralized density and time postfracture in cortical but not trabecular bone: a longitudinal hrpqct imaging study in the distal radius |
publisher |
Wiley |
series |
JBMR Plus |
issn |
2473-4039 |
publishDate |
2021-06-01 |
description |
ABSTRACT Clinical evaluation of fracture healing is often limited to an assessment of fracture bridging from radiographic images, without consideration for other aspects of bone quality. However, recent advances in HRpQCT offer methods to accurately monitor microstructural bone remodeling throughout the healing process. In this study, local bone formation and resorption were investigated during the first year post fracture in both the fractured (n = 22) and contralateral (n = 19) radii of 34 conservatively treated patients (24 female, 10 male) who presented with a unilateral radius fracture at the Innsbruck University Hospital, Austria. HRpQCT images and clinical metrics were acquired at six time points for each patient. The standard HRpQCT image acquisition was captured for all radii, with additional distal and proximal image acquisitions for the fractured radii. Measured radial bone densities were isolated with a voxel‐based mask and images were rigidly registered to images from the previous imaging session using a pyramid‐based approach. From the registered images, bone formation and resorption volume fractions were quantified for multiple density‐based thresholds and compared between the fractured and contralateral radius and relative to demographics, bone morphometrics, and fracture metrics using regression. Compared with the contralateral radius, both bone formation and resorption were significantly increased in the fractured radius throughout the study for nearly all evaluated thresholds. Higher density cortical bone formation continually increased throughout the duration of the study and was significantly greater than resorption during late‐stage healing in both the fractured and intact regions of the radius. With the small and diverse study population, only weak relationships between fracture remodeling and patient‐specific parameters were unveiled. However this study provides methods for the analysis of local bone remodeling during fracture healing and highlights relevant considerations for future studies, specifically that remodeling postfracture is likely to continue beyond 12‐months postfracture. © 2021 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research. |
topic |
ANALYSIS/QUANTITATION OF BONE BONE QUANTITATIVE COMPUTED TOMOGRAPHY (QCT) BONE MICRO‐COMPUTED TOMOGRAPHY (μCT) INJURY/FRACTURE HEALING ORTHOPAEDICS RADIOLOGY |
url |
https://doi.org/10.1002/jbm4.10493 |
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