Femoral neck fractures are a major cause of morbidity and mortality in elderly humans. In addition to the
age-related loss of cancellous bone, changes to the microstructure and morphology of the metaphyseal
cortex may be a contributing factor in osteoporotic hip fractures. Recent investigations have identified a
hypermineralised tissue on the neck of the femur and trochanteric region that increases in fractional area
with advancing age in both males (Boyce & Bloebaum, 1993) and females (Vajda & Bloebaum, 1999). The
aim of this study was to determine if the hypermineralised tissue previously observed on the proximal femur
is calcified fibrocartilage. Regional variations in the fractional area of hypermineralised tissue, cortical bone,
and porosity of the cortical bone along the neck of the femur and lesser trochanter were also quantified.
Comparison of back scattered electron and light microscope images of the same area show that regions of
hypermineralised tissue correlate with the regions of calcified fibrocartilage from tendon and capsular
insertions. The hypermineralised tissue and calcified fibrocartilage had similar morphological features such as
the interdigitations of the calcified fibrocartilage into the bone, lacunar spaces, and distinctly shaped pores
adjacent to the 2 tissues. Regions of the neck that did not contain insertions were covered with
periosteum. There were no regional differences (P > 0.05) on the superior and inferior femoral neck in terms
of the percentage area of hypermineralised calcified fibrocartilage, cortical bone, or cortical bone porosity.
The lesser trochanter exhibited regional differences in the fractional area of hypermineralised calcified
fibrocartilage (P = 0.007) and cortical bone (P = 0.007) but not porosity of the cortical bone
(P > 0.05). The effects of calcified fibrocartilage on femoral neck periosteal expansion, repair, and
mechanics are unknown, but may play a role in osteoporotic fractures and intracapsular fracture healing.