To evaluate the incidence, grade and extent of the degenerative changes in the femoral head articular cartilage in the elderly with hip fracture through gross, histological and immunohistochemical studies.

The study examined 30 femoral heads obtained from patients over 65 years with no arthrosis by radiograph, who had undertaken bipolar hemiarthroplasty due to hip fracture. The mean age of patients was 79.7 years and the study examined three weight bearing zones (anterior, middle and posterior) and one non-weight bearing zone (inferior) of each femoral head.

The gross findings showed significant correlation with the Mankin grade for each zone (p<0.05). Twenty four cases (80%) showed mild degeneration according to the Mankin grade and the others moderate. The mean Mankin score at each zone of all femoral heads was 5 points, which indicated mild degeneration. No significant difference was found between the weight bearing zone and the non-weight bearing zone (p=0.75). The distribution of type II collagen antibody stainabilities mainly showed normal or mild degeneration (93.3%).

Degeneration of the articular cartilage of the femoral heads in the elderly with hip fracture and no arthrosis by radiograph was mostly mild, and showed generalized changes regardless of the zone.