Abstract
Although an adverse relationship between osteoporosis and osteoarthritis (OA) has been reported, it remains controversial. In most previous reports of OA, bone mineral density (BMD) changes in the subtrochanteric region have not been clarified, whilst BMD of the femoral neck and trochanteric region has been well investigated. In our current study, we investigated the BMD ratio compared to the contralateral side in the whole proximal femurs of hip OA patients. We aimed to clarify the morphologic factor that may influence these BMD ratios. We performed dual energy X-ray absorptiometry (DEXA) analysis of 69 hip joints from unilateral progressed OA cases. The minimum joint space, center edge angle, Sharp angle, acetabular head index, neck–shaft angle, and leg length discrepancy were also measured as radiographic factors. The correlation between BMD ratio and radiographic morphologic factors was then evaluated by logistic regression. The BMD ratio was higher in the femoral neck than in the distal region. In terms of radiographic factors, the neck–shaft angle was revealed to influence the decreased BMD ratio in the distal subtrochanteric part, whilst the leg length discrepancy and Sharp angle showed a relationship with the increased BMD ratio in the proximal neck region. The discrepancy in the BMD ratio between the femoral neck and the distal subtrochanteric region in the proximal femur is influenced by several morphologic factors.
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References
Burr DB, Gallant MA (2012) Bone remodelling in osteoarthritis. Nat Rev Rheumatol 8:665–673
Lajeunesse D, Reboul P (2003) Subchondral bone in osteoarthritis: a biologic link with articular cartilage leading to abnormal remodeling. Curr Opin Rheumatol 15:628–633
Shen Y, Zhang YH, Shen L (2013) Postmenopausal women with osteoporosis and osteoarthritis show different microstructural characteristics of trabecular bone in proximal tibia using high-resolution magnetic resonance imaging at 3 tesla. BMC Musculoskelet Disord 14:136
Li ZC, Dai LY, Jiang LS, Qiu S (2012) Difference in subchondral cancellous bone between postmenopausal women with hip osteoarthritis and osteoporotic fracture: implication for fatigue microdamage, bone microarchitecture, and biomechanical properties. Arthritis Rheum 64:3955–3962
Antoniades L, MacGregor AJ, Matson M, Spector TD (2000) A cotwin control study of the relationship between hip osteoarthritis and bone mineral density. Arthritis Rheum 43:1450–1455
Arden NK, Nevitt MC, Lane NE, Gore LR, Hochberg MC, Scott JC, Pressman AR, Cummings SR (1999) Osteoarthritis and risk of falls, rates of bone loss, and osteoporotic fractures. Study of Osteoporotic Fractures Research Group. Arthritis Rheum 42:1378–1385
Cooper C, Cook PL, Osmond C, Fisher L, Cawley MI (1991) Osteoarthritis of the hip and osteoporosis of the proximal femur. Ann Rheum Dis 50:540–542
Nevitt MC, Lane NE, Scott JC, Hochberg MC, Pressman AR, Genant HK, Cummings SR (1995) Radiographic osteoarthritis of the hip and bone mineral density. The Study of Osteoporotic Fractures Research Group. Arthritis Rheum 38:907–916
Stewart A, Black A, Robins SP, Reid DM (1999) Bone density and bone turnover in patients with osteoarthritis and osteoporosis. J Rheumatol 26:622–626
Sandini L, Arokoski JP, Jurvelin JS, Kroger H (2005) Increased bone mineral content but not bone mineral density in the hip in surgically treated knee and hip osteoarthritis. J Rheumatol 32:1951–1957
Gruen TA, McNeice GM, Amstutz HC (1979) “Modes of failure” of cemented stem-type femoral components: a radiographic analysis of loosening. Clin Orthop Relat Res (141):17–27
Burger H, van Daele PL, Odding E, Valkenburg HA, Hofman A, Grobbee DE, Schutte HE, Birkenhager JC, Pols HA (1996) Association of radiographically evident osteoarthritis with higher bone mineral density and increased bone loss with age. The Rotterdam Study. Arthritis Rheum 39:81–86
Rubinacci A, Tresoldi D, Scalco E, Villa I, Adorni F, Moro GL, Fraschini GF, Rizzo G (2012) Comparative high-resolution pQCT analysis of femoral neck indicates different bone mass distribution in osteoporosis and osteoarthritis. Osteoporos Int 23:1967–1975
Arokoski JP, Arokoski MH, Jurvelin JS, Helminen HJ, Niemitukia LH, Kroger H (2002) Increased bone mineral content and bone size in the femoral neck of men with hip osteoarthritis. Ann Rheum Dis 61:145–150
Paggiosi MA, Glueer CC, Roux C, Reid DM, Felsenberg D, Barkmann R, Eastell R (2011) International variation in proximal femur bone mineral density. Osteoporos Int 22:721–729
Masuhara K, Kato Y, Ejima Y, Fuji T, Hamada H (1994) Bone mineral assessment by dual-energy X-ray absorptiometry in patients with coxarthrosis. Int Orthop 18:215–219
Vanden Berg-Foels WS, Schwager SJ, Todhunter RJ, Reeves AP (2011) Femoral head bone mineral density patterns may identify hips at risk of degeneration. Ann Biomed Eng 39:75–84
Chang KH, Lai CH, Chen SC, Tang IN, Hsiao WT, Liou TH, Lee CM (2011) Femoral neck bone mineral density in ambulatory men with poliomyelitis. Osteoporos Int 22:195–200
Brownbill RA, Ilich JZ (2003) Hip geometry and its role in fracture: what do we know so far? Curr Osteoporos Rep 1:25–31
Gnudi S, Sitta E, Pignotti E (2012) Prediction of incident hip fracture by femoral neck bone mineral density and neck-shaft angle: a 5-year longitudinal study in post-menopausal females. Br J Radiol 85:e467–e473
Im GI, Lim MJ (2011) Proximal hip geometry and hip fracture risk assessment in a Korean population. Osteoporos Int 22:803–807
Ito M, Wakao N, Hida T, Matsui Y, Abe Y, Aoyagi K, Uetani M, Harada A (2010) Analysis of hip geometry by clinical CT for the assessment of hip fracture risk in elderly Japanese women. Bone 46:453–457
Dequeker J, Johnell O (1993) Osteoarthritis protects against femoral neck fracture: the MEDOS study experience. Bone 14(Suppl 1):S51–S56
Hoaglund FT, Shiba R, Newberg AH, Leung KY (1985) Diseases of the hip. A comparative study of Japanese Oriental and American white patients. J Bone Joint Surg Am 67:1376–1383
Nelitz M, Guenther KP, Gunkel S, Puhl W (1999) Reliability of radiological measurements in the assessment of hip dysplasia in adults. Br J Radiol 72:331–334
Reijman M, Hazes JM, Koes BW, Verhagen AP, Bierma-Zeinstra SM (2004) Validity, reliability, and applicability of seven definitions of hip osteoarthritis used in epidemiological studies: a systematic appraisal. Ann Rheum Dis 63:226–232
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Kobayashi, N., Inaba, Y., Yukizawa, Y. et al. Bone mineral density distribution in the proximal femur and its relationship to morphologic factors in progressed unilateral hip osteoarthritis. J Bone Miner Metab 33, 455–461 (2015). https://doi.org/10.1007/s00774-014-0610-x
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DOI: https://doi.org/10.1007/s00774-014-0610-x