Femur Head Necrosis
Conditions
Keywords
aseptic osteonecrosis, femoral head, micro scanner, Raman spectrometry, MRI
Brief summary
In this study, the aim is to identify the modifications responsible for aseptic osteonecrosis of the femoral head and its structural evolution by the association of the micro scanner analysis and Raman spectrometry performed on the femoral heads removed during hip replacements. The study of femoral heads will allow the analysis of bone tissue at two different scales, both correlated with the biomechanical properties of the bone. Also, the association with preliminary MRI analysis will provide pathogenic explanations correlated to these modifications.
Interventions
PROCEDUREfemoral head removal
Sponsors
Lille Catholic University
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
BASIC_SCIENCE
Masking
NONE
Eligibility
Sex/Gender
MALE
Age
25 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
for experimental group: * Men * Patients aged from 25 to 70 years * Patient with an aseptic osteonecrosis of the femoral head established by medical Imaging (CT-scan, MRI or radiography) * FICAT stage 3 or 4 * osteonecrosis etiologies : alcohol, corticosteroid therapy, idiopathic * Surgical indication of hip prosthesis determined Inclusion Criteria for control group: * Men * Patients aged from 40 to 70 years * Patient with a primitive coxarthrosis * Surgical indication of hip prosthesis determined
Exclusion criteria
for the 2 groups: * Other causes of osteonecrosis (coagulopathy, barotrauma, trauma) * Prior fracture of the upper extremity of the femur * Prior cancer and hematological malignancies with bone locations * Prior debilitating bone diseases * Patient refusal to participate in the study * Patient who isn't affiliated to a social security regimen
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Osseous modifications responsible of osteonecrosis | through the study completion, an average of 18 months |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Total cross-sectional area | through the study completion, an average of 27 months | by using a contrast-enhanced nano-CT for the subchondral plate in necrotic zone, juxta-necrotic zone, remotely of the necrotic zone and cortical of the femoral collar |
| cortical bone area | through the study completion, an average of 27 months | by using a contrast-enhanced nano-CT for the subchondral plate in necrotic zone, juxta-necrotic zone, remotely of the necrotic zone and cortical of the femoral collar |
| cortical area fraction | through the study completion, an average of 27 months | by using a contrast-enhanced nano-CT for the subchondral plate in necrotic zone, juxta-necrotic zone, remotely of the necrotic zone and cortical of the femoral collar |
| cortical thickness | through the study completion, an average of 27 months | by using a contrast-enhanced nano-CT for the subchondral plate in necrotic zone, juxta-necrotic zone, remotely of the necrotic zone and cortical of the femoral collar |
| bone volume fraction | through the study completion, an average of 27 months | by using a contrast-enhanced nano-CT for the subchondral trabecular bone |
| trabecular number | through the study completion, an average of 27 months | by using a contrast-enhanced nano-CT for the subchondral trabecular bone |
| trabecular separation | through the study completion, an average of 27 months | by using a nano-CT for the subchondral trabecular bone |
| trabecular thickness | through the study completion, an average of 27 months | by using a contrast-enhanced nano-CT for the subchondral trabecular bone |
| Physico-chemical composition of the trabecular subchondral bone | through the study completion, an average of 27 months | mineralisation, carbonation, crystallinity, secondary structure of collagen, maturity of collagen, relative content of proteoglycans. These measures will be done for the trabecular subchondral bone in necrotic zone, juxta-necrotic zone, remotely of the necrotic zone and in the cortical of the femoral collar |
| Existence and extent of edema | through the study completion, an average of 27 months | this measure will be done on the T2-weighted sequences with fat suppression |
| Perfusion MRI sequence | through the study completion, an average of 27 months | morphological aspect of the enhancement curve, semi-quantitative parameters (slope, area under the curve, time to peak) and pharmacokinetic parameters |
| Medullary fat fraction in T1-weighted DIXON method | through the study completion, an average of 27 months | border of osteosclerosis, identification of a necrotic zone, extent of this zone |
| Evaluation of osteocyte and adipocyte viability in hematoxylin-eosin-saffron (HES) staining | through the study completion, an average of 27 months | — |
| Number and ramifications of sub-chondral microvessels by immuno-labeling with CD21 | through the study completion, an average of 27 months | — |
| Evaluation of the number of osteoclasts by TRAP (tartrate acid Phosphatase) staining | through the study completion, an average of 27 months | — |
| Mankin score for cartilage degradation by Safranin O staining | through the study completion, an average of 27 months | — |
Countries
France
Contacts
PRINCIPAL_INVESTIGATORTristan Pascart, MD
Hospital Group of the Catholic Institute of Lille
Outcome results
None listed