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Loss of sympathetic nerve fibers in vital intertrochanteric bone cylinders lateral to osteonecrosis of the femoral head.

Abstract

OBJECTIVES
Although etiology in osteonecrosis of the femoral head mainly depends on alterations of bone blood flow, vasoregulatory nerve fibers of the sympathetic and sensory nervous system have never been investigated in bone of osteonecrosis patients. This study aimed to demonstrate density of sympathetic and sensory nerve fibers in femoral head and, for comparison, adjacent periosteum, and synovium of the hip joint in patients with osteonecrosis.
METHODS
Immunofluorescence staining techniques were applied using specific nerve fiber markers. A total of 10 patients with early femoral head osteonecrosis (ARCO I-II), 10 with late femoral head osteonecrosis (ARCO III-IV), and 10 patients with osteoarthritis of the hip were investigated.
RESULTS
In the bone of the femoral head, density of sympathetic nerve fibers was lower in early and late osteonecrosis compared to osteoarthritis. There was a marked preponderance of sympathetic over sensory nerve fibers in bone of osteoarthritis patients, which was opposite in early and late femoral head osteonecrosis. In periosteum, density of sympathetic nerve fibers was similar in all three groups but density of sensory nerve fibers and cellularity were higher in early osteonecrosis compared to the other two groups.
DISCUSSION/CONCLUSIONS
Due to the different affinity of norepinephrine for α-adrenoceptors (high affinity) and β-adrenoceptors (low affinity), the loss of sympathetic nerve fibers relative to sensory nerve fibers in femoral head osteonecrosis might change the femoral head blood flow (towards α-adrenergic vasoconstriction). Higher density of sensory nerve fibers and cellularity in periosteum might indicate an inflammatory response in early osteonecrosis.

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  • Publisher Full Text
  • Authors

    Beckmann J, Knödl M, Bauser E, Tingart M, Grifka J, Straub RH

    Institution

    Department of Orthopedic Surgery, University Hospital Regensburg, Asklepios Clinic Bad Abbach, Regensbur, Germany.

    Source

    Joint, bone, spine : revue du rhumatisme 80:2 2013 Mar pg 188-94

    MeSH

    Adult
    Aged
    Biological Markers
    Female
    Femur Head
    Femur Head Necrosis
    Fluorescent Antibody Technique
    Hip Joint
    Humans
    Male
    Middle Aged
    Nerve Fibers
    Osteoarthritis, Hip
    Periosteum
    Sensory Receptor Cells
    Sympathetic Nervous System
    Synovial Membrane

    Pub Type(s)

    Comparative Study
    Journal Article

    Language

    eng

    PubMed ID

    22575068