The first three authors contributed equally to this study and therefore share first authorship.
Bone microarchitecture of the calcaneus and its changes in aging: A histomorphometric analysis of 60 human specimens†
Article first published online: 2 MAR 2006
Copyright © 2006 Orthopaedic Research Society.
Journal of Orthopaedic Research
Volume 24, Issue 4, pages 664–674, April 2006
How to Cite
Rupprecht, M., Pogoda, P., Mumme, M., Rueger, J. M., Püschel, K. and Amling, M. (2006), Bone microarchitecture of the calcaneus and its changes in aging: A histomorphometric analysis of 60 human specimens. J. Orthop. Res., 24: 664–674. doi: 10.1002/jor.20099
- Issue published online: 21 MAR 2006
- Article first published online: 2 MAR 2006
- Manuscript Accepted: 10 OCT 2005
- Manuscript Received: 19 AUG 2005
- bone structure
Bone structure and quality are an important parameter in the propensity of bone to fracture. Although the calcaneus is used as diagnostic reference site for osteoporosis by ultrasound, its structure has never been analyzed in detail. The purpose of this study was therefore to histomorphometrically analyze the trabecular microarchitecture of the calcaneus, and to determine whether the calcaneal bone structure is changing with age. Sixty complete human calcanei were harvested from thirty age- and gender-matched patients at autopsy. Each of the three different age groups (group I: 20 to 40, group II: 41 to 60, group III: 61 to 80 years of age) was represented by 20 specimens. The specimens were subjected to radiographic, µCT, and histologic analysis. Bone structure and bone mass of the calcaneus were quantified for three different regions of interest: the anterior ROI, the superior ROI (the subtalar region under the posterior facet), and the posterior ROI. An iliac crest biopsy was obtained from all patients to exclude any metabolic bone disease. Histomorphometric analysis revealed significant differences in bone volume within the calcaneus with highest values in the superior ROI: age group I: 31.3% (27.8–34.8%); II: 25.5% (22.1–28.9%); III: 18.9% (16.6–21.2%) and lowest bone volumes in the anterior ROI; age group I: 6.2% (4.8–7.6%); II: 3.6% (2.1–5.1%); III: 3.9% (2.9–4.9%). There was a significant age-related decrease in bone volume (BV/TV) in aging. Interestingly, this bone loss was most prominent in the superior ROI, with a 39% decrease in BV/TV between age group I and III (p < 0.001). Qualitative and structural analysis of trabecular number, thickness, and spacing demonstrated that the bone loss in the thalamic portion of the calcaneus was due to the transition of plate-like trabecular elements into a rod-like structure. In conclusion, our study demonstrated that the calcaneus displayed age-related changes in its microarchitecture that are known to reduce the biomechanical stability of trabecular bone, and that the age-related bone loss was most prominent in the region adjacent to the posterior facet (superior ROI). These results suggest that bone mass and structure are risk factors in respect to the occurrence and severity of calcaneal fractures, and indicate that calcaneal fractures are at least in part osteoporotic fractures. © 2006 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res