Articular cartilage mineralization in osteoarthritis of the hip.
BACKGROUND
The aim of this study was to examine the frequency of articular cartilage calcification in patients with end-stage hip OA. Further, its impact on the clinical situation and the OA severity are analyzed.


METHODS
Eighty patients with OA of the hip who consecutively underwent total hip replacement were prospectively evaluated, and 10 controls were included. The patients' X-rays were analyzed for the presence of articular cartilage mineralization. A Harris Hip Score (HHS) was preoperatively calculated for every patient.Slab specimens from the femoral head of bone and cartilage and an additional square centimeter of articular cartilage from the main chondral defect were obtained from each patient for analysis of mineralization by digital contact radiography (DCR). Histological grading was also performed. In a subset of 20 patients, minerals were characterized with an electron microscope (FE-SEM).


RESULTS
Calcifications were seen in all OA cartilage and slab specimens using DCR, while preoperative X-rays revealed calcification in only 17.5%. None of the control cartilage specimens showed mineralization. There was a highly significant inverse correlation between articular cartilage calcification and preoperative HHS. Histological OA grade correlated positively with the amount of matrix calcification. FE-SEM analysis revealed basic calcium phosphate (BCP) as the predominant mineral; CPPD crystals were found in only two patients.


CONCLUSIONS
Articular cartilage calcification is a common event in osteoarthritis of the hip. The amount of calcification correlates with clinical symptoms and histological OA grade.
Fuerst
Martin
M
Department of Orthopedic Surgery, University Medical Center Hamburg-Eppendorf, Clinic Bad Bramstedt, Martinistr 52, 20465 Hamburg, Germany. mfuerst@uke.uni-hamburg.de
Niggemeyer
Oliver
O
Lammers
Lydia
L
Schäfer
Fritz
F
Lohmann
Christoph
C
Rüther
Wolfgang
W
D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip; D002113:Calcification, Physiologic / Q000502:physiology; D002114:Calcinosis / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000473:pathology*; D017610:Calcium Compounds / Q000737:chemistry / Q000378:metabolism; D002358:Cartilage, Articular / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D015897:Comorbidity; D018450:Disease Progression; D005260:Female; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000473:pathology*; D015995:Prevalence; D011859:Radiography
D017610:Calcium Compounds