Table 3.
Un-decalcified iliac crest biopsy histopathology results demonstrating high bone formation/remodelling and resolution of osteomalacia at 18-months follow-up.
| Parameter | Pre-operative result | Post-operative result | Normal range for men 40–60 years old |
|---|---|---|---|
| Trabecular bone area | 6.9L | 32.4H | 21–29% |
| Cortical width | – | 1.18 | 0.8–1.4 mm |
| Relative osteoid area | 60.4H | 4.8H | 1.3–3.1% |
| Total osteoid surface | 75H | 38.3H | 7.1–13.9% |
| Active resorption surface | 1.3 | 1.1 | 0.5–2.5% |
| Total resorption surface | 3.6 | 5.2 | 2.2–6.7% |
| Osteoclasts number | 2.8H | 0.6 | 0.3–1.3 cells/cm2 |
| Double label surface | Tetracycline smearing | 32.6H | 4.2–11.6% |
| Mineral appositional rate | Tetracycline smearing | 1.58H | 0.60–0.80 mm/day |
| Bone formation rate | Tetracycline smearing | 0.52H | 0.03–0.09 mm3/mm2/day |
| Osteoid seam width | 36.8H | 26.8H | 9.2–14.9 μm |
| Mineralisation lag time | – | 20.3 | 12.1–19.9 days |
| Fibrous area | 0 | 0.5 | 0% |
| Aluminium surface | 0 | 0 | 0% |
H = high, L = low
Results demonstrate pre-operative reduced trabecular bone area, hyperosteoidosis, increased osteoclast number and tetracycline smearing suggestive of severe osteomalacia. At 18-months follow-up, mildly increased trabecular bone area, increased osteoid surface and thickness and increased bone formation rate with normal mineralisation lag time indicated high bone formation/remodelling and absence of osteomalacia.