Figure 1

Overview of the comprehensive analysis of AVNFH and control samples. Bone and plasma samples as well as retrospective clinical chemistry data from patients with Avascular Necrosis of Femoral Head (AVNFH) and healthy controls were used in this study. Control individuals visited the hospital for treatment of bone fractures and had no history of AVNFH. Retrospective clinical chemistry data from 69 AVNFH and 71 controls were analysed. In addition, age and gender matched plasma samples collected prior to surgery (AVNFH n = 30) and during routine clinical visit (for controls, n = 31) were used for mass spectrometry-based analysis of selected set of metabolites associated with homocysteine pathway. Bone samples were collected post-surgery (AVNFH, n = 13) or during treatment of fractured bones (controls, n = 7) and used for morphological, histopathological, and biophysical studies. Biophysical studies involved analysis of matrix composition using Micro-Raman spectroscopy and Raman mapping, analysis of bone architecture using Scanning Electron Microscopy (SEM), and analysis of bone mineral density using Computer Assisted Tomography scans as described in the text. Red, Green and yellow arrows/lines indicate elevated, reduced and unchanged levels respectively of assayed parameters in AVNFH versus control samples.