Sophie A. Feik

Age-related changes in cortical porosity of the midshaft of the human femur

Complete cross‐sections from the femoral midshaft of 180 individuals of known height and weight, aged 21–97 y, from a modern Australian population were examined using automatic video image analysis to quantify total subperiosteal porosity (TSPP). More specifically, the aim was to investigate whether age changes were similar in both sexes in (1) total subperiosteal area (TSPA), cortical area (CA) and medullary area (MA), (2) intracortical porosity (ICP), and (3) the respective contributions to TSPP made by MA and intracortical void area (ICVA). Our findings indicated that both sexes showed a significantly greater height normalised TSPA in the 70s as compared with the 20s. Males had consistently larger bones with a greater height normalised CA. In both sexes CA showed a tendency to increase till the 7th decade and then to decline, more so in females. MA approximately trebled in females and doubled in males over the age range studied. Although ICP also increased, from 4–6% in young adults to over 9% in the elderly, it showed a significant difference between the sexes only in the 3rd decade, being greater in males at this stage. By contrast, TSPP became significantly greater in females (from that recorded in the 3rd decade) by the time they reached the 50s, while in males this did not occur till the 80s. It increased from ∼25% in young adults of both sexes to ∼50% in females and ∼37% in males in their 80s. However, in the elderly there was great variability in both sexes in the appearance of bones from individuals of similar chronological age. Some bones differed little from those in younger subjects, others showed greatly increased ICP, still others displayed reduced cortical widths with low ICP. The femoral midshaft resembles other skeletal sites in that age changes in TSPP are more marked in females than males.

Regional variation of intracortical porosity in the midshaft of the human femur: age and sex differences

This study investigated age and sex differences in patterns of porosity distribution in the midshaft of the human femur. Cross‐sections were obtained from 168 individuals from a modern Australian population. The sample comprised 73 females and 95 males, aged between 20 and 97 years. Microradiographs were made of 100‐µm sections and pore and bone areas were determined using image processing software. Initially the sample was divided by age: young (20–44 years), middle (45–64 years) and old (65+ years), but it was found that analysis on the basis of the ratio of medullary area to total subperiosteal area gave clearer results. The cortex was divided into three rings radially and into octants circumferentially and the porosity of each segment was calculated. Results showed that a pattern with raised porosity in the posterior and anterolateral regions, and with greater porosity in the inner parts of the cortex, becomes more pronounced with age. In males this pattern develops steadily; in females there are much greater differences between the middle and older groups than earlier in life. The patterns observed are consistent with progressive bone loss occurring along a neutral axis of the cortex where bending stress is lowest and the mechanical advantage of the bone is least.

Super-osteons (remodeling clusters) in the cortex of the femoral shaft: influence of age and gender.

Previous studies of cortical remodeling in the fractured femoral neck indicated that the merging of spatially clustered remodeling osteons could result in the formation of deleteriously large cavities associated with femoral neck fracture. This study aimed to identify whether remodeling osteons in the femoral shaft were also clustered and to assess the influence of age and gender. Microradiographic images of femoral mid‐shaft cross‐sections from 66 subjects over 21 years of age were analyzed to determine the number, size and location of all Haversian canals. Those most recently remodeled were identified using an edge‐detection algorithm highlighting the most marked differential gradients in grey levels. Cluster analysis (JMP software) of these osteons identified the proportion of recently remodeled osteons that were within 0.75mm clusters. As in the femoral neck, remodeling osteons were significantly more clustered than could occur by chance (real, 59.4%; random, 39.4%; P < 0.0001). The density of these clusters (number/mm2) was not significantly associated with subject age or gender but was greatest near the periosteum and decreased toward the marrow cavity (periosteal 0.043 ± 0.004; mid‐cortex 0.028 ± 0.003; endosteal 0.017 ± 0.002). Cortical porosity increased with age. The presence of giant canals (diameter >385μm) was inversely related to the presence of clusters (R2 = 0.237, P < 0.0001). This data suggest that remodeling osteons tend to be spatially colocalized in the shaft as they are in the neck of the femur and their presence is independent of age or gender. We propose that these remodeling clusters be termed super‐osteons. The negative relationship between super‐osteons and giant canals raises the intriguing possibility that loss of the control of remodeling depth results in the merging of osteonal systems to form deleteriously large cortical cavities with a marked reduction in bone strength. Anat Rec 264:378–386, 2001.

Regional variations in cortical modeling in the femoral mid-shaft: sex and age differences.

Modern lifestyle changes may result in site-specific alterations in the skeleton. Our aim was to determine sex and age differences in regional geometry at the mid-femur. Complete cross sections from 113 individuals aged 20-97 years from a modern Australian population were obtained. A further subsample of 24, in whom the precise orientation of specimens was known, was subsequently collected. Microradiographs were made of 100-microm sections and the bone was analyzed using image processing software (Optimas, Media Cybernetics). The periosteal boundary was extracted automatically and the centroid of the periosteal outline was calculated. Fourier shape analysis was used to delineate the endocortical surface. Radial and cortical widths in each quadrant were determined. The posterior was identified by the linea aspera, and the medial and lateral were indistinguishable and therefore grouped together. For analysis, the entire sample was divided into three groups: young (20-40 years), middle (41-60 years), and old (61+ years). Raw and height-normalized values were analyzed with SPSS using t-tests, analysis of variance, and Tukeys honestly significant difference (HSD) tests. The results show that with age the femoral mid-shaft in both sexes becomes larger and more circular, with a slight shift towards the anterior. Apposition is least on the posterior and resorption greatest on the anterior, the latter being particularly evident in postmenopausal females. The greatest sex differences are seen in the middle years, lessening again in the old. We conclude that differential circumferential modeling in response to functional and postural changes occurs in both sexes with age.

An automated analysis of intracortical porosity in human femoral bone across age

The matrix of human cortical bone is arranged around a network of vascular spaces (hereafter referred to as “pores”). Our aim was to investigate age‐related differences in human cortical porosity (total pore area divided by cortical bone area), pore size and number, and surface to volume ratios, while adjusting for sex, height, and weight. Ninety‐six specimens of entire transverse sections of human femoral diaphysis, from subjects aged 21–92 years, were examined. We used our established automated image acquisition and analysis system which measures pores from entire sections of multiple specimens of bone. Over 400,000 pores were recorded. Results showed a greater porosity in older bone (p < 0.01) but marked variation in porosity for any given age. The cohort median, of the specimen medians, of pore cross‐sectional area was 2050 μm2. Older specimens did not have more pores than younger specimens but had a greater proportion of larger pores (p < 0.05) and greater intraspecimen variation in pore size (p < 0.001). The pore surface to bone matrix volume ratio was a median 2.3 mm2/mm3. This varied more than 4‐fold between individuals but did not relate to age. No simple relationships were found between any of the measured parameters and either sex, height, or weight, even after adjustment for age. We conclude that the greater porosity in older specimens is due to greater pore size rather than a larger number of pores. Age, however, explains little of the inter‐individual variation in the parameters studied.

Increase in pore area, and not pore density, is the main determinant in the development of porosity in human cortical bone

This study investigated the relative contributions of pore size and pore density (number of pores per mm2) to porosity in the midshaft of the human femur. Cross‐sections were obtained from 168 individuals from a modern Australian population (mostly Anglo‐Celtic). The study group comprised 73 females and 95 males, aged from 20 to 97 years. Microradiographs were made of 100‐µm sections and porosity, pore areas and pore densities determined using image processing software. The cortex was divided into three rings radially and into octants circumferentially, and the porosity, pore area and pore density of each segment were calculated. Results show that 81% of the variance in porosity can be explained by changes in mean pore area with only a further 12–16% explained by changes in pore density. These effects were found to be constant across all areas of the cortex and in both sexes. These results are significant in their consistency and ordered gradation and indicate a well‐regulated and systematic process of bone removal with ageing. The results show a regular progression from less porous to more porous bone; this is a uniform process that occurs in all individuals, and factors such as sex and rate of ageing determine where on this continuum any individual is at a particular time.

Determination of age at death using combined morphology and histology of the femur.

Bone is characterised by age‐related morphological and histological changes. We have previously established an automated method of recording bone morphometry and histology from entire transverse sections of cortical bone. Our aim was to determine whether data acquired using this automated system were useful in the prediction of age. Ninety‐six specimens of human femoral middiaphysis were studied from subjects aged 21–92 y. Equations predicting specimen age were constructed using macroscopic data (total subperiosteal area (TSPA), periosteal perimeter (PP), endosteal perimeter (EP), cortical bone area (CA) and moments of area) and microscopic data (the number, size and diversity of pores and intracortical porosity) together with sex, height and weight. Both TSPA and PP were independent predictors of age but the number of pores was not a significant predictor of age in any equation. The age predicted by these equations was inaccurate by more than 8 y in over half the subjects. We conclude that we could not predict age at a clinically acceptable level using data from our automated system. This most likely reflects an insensitivity to regional age‐related changes in bone histology because we recorded data from each entire cortex. Automated bone measurement according to cortical region might be more useful in the prediction of age. The inclusion of TSPA together with PP as independent predictors of age raises the possibility that a future measure of periosteal shape at the femoral diaphysis could also be helpful in the prediction of age. The accuracy reached with the relatively simple methods described here is sufficient to encourage the development of image‐analysis systems for the automatic detection of more complex features.

Sealing ability of three materials used to repair lateral root perforations.

Thirty-five extracted single-rooted human teeth were decoronalized, root filled with AH-26 and gutta-percha, and perforated at the apical one third level. Repairs of the lateral perforations were carried out with three materials: amalgam plus cavity varnish, EBA cement, and silver glass-ionomer cement. Negative controls were not perforated and positive controls had unrepaired perforations. The roots were then implanted subcutaneously in rats for 5 days to place the materials in a surgical environment. Following retrieval, the roots were placed in a solution containing 20 microCi/ml of calcium-45 for 7 days to measure microleakage. They were rinsed, sectioned, and autoradiographs of the repaired perforations were made. The autoradiographs were projected onto a screen and the extent of penetration of the radioisotope measured. Statistical analysis showed that the EBA cement group exhibited significantly less leakage than the silver glass-ionomer cement group (p < 0.05). No differences were found between the other groups. It was concluded that EBA cement provides a superior seal in lateral root perforations to silver glass-ionomer cement while amalgam was intermediate between the two.

Low-Calcium/High Phosphorus Rickets in Rats. I. Mast Cell Changes

&NA; Weanling rats were given a low Ca (0.003%)/high P (0.64%) diet with and without vitamin D for periods up to 5 weeks. This was associated with hypocalcaemia, rachitic bone changes and increased bone resorption. These changes preceded the accumulation of large numbers of mast cells in long bone metaphyses. Mast cells did not increase in the epiphyses of long bones or in caudal vertebrae, tooth pulp, skin and other organs. A light and electron microscopic study showed that most mast cells had raised secretory activity, as evidenced by variability in the structure of granules and loss of granule contents, particularly in animals with the lowest serum calcium levels. It was not possible to relate the position of a mast cell to an area of active bone formation or resorption. The increase in mast cells might be related more to the maintenance of connective tissue integrity in areas of rapid bone remodelling.

Joint changes in transplanted caudal vertebrae

Summary Both straight and bent segments of tails from 4‐d‐old and weanling Sprague‐Dawley rats were used to study the changes which occur in symphyseal joints on transplantation to non‐functional sites. In the joints from the younger donors ankylosis occurred almost invariably in the proximal end of the tail, while distally it was rarely seen unless the tail was curved, when ankylosis was visible on the inner side of the bend. The joints from the older donors showed a more varied response on transplantation. Some appeared unaltered, in others where growth continued, calcific changes were seen. In bent segments, unlike in younger ones, ankylosis occurred preferentially on the outer side of the bend. Histological examination revealed that ankylosis of the joint occurred through a process of chondroid metaplasia of the intervertebral connective tissue with subsequent replacement by bone. The metaplastic joint changes were primarily the result of pressure producing compression of the annulusfibrosus in tissues with a reduced vitality due to transplantation and lack of function.