Summary
Forty patients with unilateral osteoarthritis of the hip were studied with dual energy X-ray absorptiometry to quantify disuse osteopenia in their affected leg by examining the proximal femur and tibia. Bone loss was assessed as a percentage of the contralateral value which compares bone mineral density of the affected and normal sides. The percentage contralateral value in the femoral neck and Ward's triangle was 113% and 118% respectively, while that in the tibia was 75%. Bone loss in the proximal tibia of the affected leg could be of value in assessing gait since it correlates with the gait parameters on the hip rating scale. By contrast, bone mineral increase in the proximal femur and correlates only with the degree of valgus deformity of the femoral neck.
Résumé
Quarante patients atteints de coxarthrose ont été examinés par absorptiométrie radiologique à double énergie afin de mesurer l'ostéopénie du côté malade. L'étude a été essentiellement centrée sur le fémur et le tibia proximal. La perte osseuse a été évaluée quantitativement selon une valeur dite “pourcentage controlatéral” (% CL), qui consiste dans la comparaison entre la densité minérale osseuse du côté sain et celle du côté atteint. Pour le col du fémur et le triangle de Ward, le % CL s'établit respectivement à 113% (p<0.01) et 118% (p<0.01), et à 75% (p<0.01) pour le tibia. Le % CL du tibia proximal témoigne de la perte osseuse du côté atteint et pourrait avoir un intérêt clinique pour évaluer la marche, car il concorde avec les paramètres de celle-ci sur l'échelle de cotation de la hanche, par exemple le rapport entre claudication et distance parcourue. Par contre, le % CL du fémur proximal montre un accroissement de la densité minérale osseuse qui ne concorde qu'avec le degré de déformation du col du fémur.
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Masuhara, K., Kato, Y., Ejima, Y. et al. Bone mineral assessment by dual-energy X-ray absorptiometry in patients with coxarthrosis. International Orthopaedics 18, 215–219 (1994). https://doi.org/10.1007/BF00188325
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DOI: https://doi.org/10.1007/BF00188325