Abstract
BACKGROUND: The incidence of osteonecrosis of the femoral head (ONFH) in people with human immunodeficiency virus (HIV) is 10-100 times higher than that in the general population. However, the specific bone microstructure and extent of damage within the femoral head in PWH are still unclear. METHODS: Femoral head samples were obtained by total hip arthroplasty, micro-computed tomography (micro-CT) was employed to investigate the microstructure of trabecular bone across 4 representative regions within necrotic femoral heads, and quantitative analysis was performed. RESULTS: On general observation, different degrees of degenerative cartilage, fibrocartilage, hyperplastic bone, and exposed bone were presented alternately, with a "map-like" appearance. On micro-CT, compared with the normal and necrotic areas, the bone volume/tissue volume and bone mineral density of the sclerotic areas were significantly increased, the number of trabeculae was significantly increased, and the gap was smaller (P < .05). There was no significant difference in trabecular thickness among the groups (P < .05). CONCLUSIONS: The systemic immune syndrome caused by HIV itself may interfere with the normal metabolism of bone, including osteoblasts and osteoclasts, and thus participate in HIV-related ONFH.