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Patients With Knee Osteoarthritis Have a Phenotype With Higher Bone Mass, Higher Fat Mass, and Lower Lean Body Mass

  • Clinical Research
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

Although knee osteoarthritis (OA) is common, its etiology is poorly understood. Specifically, it is not known whether knee OA is associated with abnormal anthropometric and musculoskeletal characteristics known to be associated with OA in general. We recently studied this topic for patients with hip arthritis; however, it is important to evaluate it for knee OA separately, because there are reports indicating that patients with primary OA in different joints may have a different phenotype.

Questions/purposes

Do patients with primary knee OA have a phenotype with higher bone mineral density (BMD), higher body mass index (BMI), larger skeletal size, lower lean body mass, and higher fat content?

Methods

We included 38 women and 74 men (mean age, 61 years; range, 34–85 years) with primary knee OA and 122 women and 121 men as control subjects. We used dual-energy x-ray absorptiometry to measure total body BMD (g/cm2), femoral neck width (cm), fat and lean mass (%), and BMI (kg/m2). Z scores were calculated for each individual. Data are presented as means with 95% confidence intervals.

Results

Women with knee OA had the following Z scores: total body BMD 0.8 (0.5–1.0); BMI 1.6 (1.1–2.0); femoral neck width 0.1 (–0.3 to 0.4); proportion of lean mass –1.0 (–1.5 to –0.6); and proportion of fat mass 1.0 (0.6–1.4). Men with knee OA had the following Z scores: total body BMD 0.5 (0.3–0.7); BMI 0.9 (0.6–1.1); femoral neck width 0.3 (0.1–0.7); proportion of lean mass –0.9 (–1.1 to –0.8); and proportion of fat mass 0.7 (0.5–0.9).

Conclusions

Women and men with idiopathic knee OA have a phenotype with higher BMD, higher BMI, proportionally higher fat mass, and proportionally lower lean body mass. Men also have a larger skeletal size.

Clinical Relevance

A higher BMD may lead to stiffer bone, a higher BMI to a greater joint load, and a proportionally lower lean body (muscle) mass to lower joint-protective ability, and all trait deviations probably predispose for knee OA.

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Authors and Affiliations

  1. Clinical and Molecular Osteoporosis Research Unit, Departments of Orthopedics and Clinical Sciences, Lund University, Skåne University Hospital, 205 02, Malmö, Sweden

    Magnus K. Karlsson MD, PhD, Håkan Magnusson MD, PhD, Maria Cöster MD, Caroline Karlsson MD, PhD & Björn E. Rosengren MD, PhD

Authors
  1. Magnus K. Karlsson MD, PhD
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  2. Håkan Magnusson MD, PhD
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  3. Maria Cöster MD
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  4. Caroline Karlsson MD, PhD
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  5. Björn E. Rosengren MD, PhD
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Corresponding author

Correspondence to Magnus K. Karlsson MD, PhD.

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Each author certifies that he or she, or a member of his or her immediate family, has no funding or commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

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Clinical Orthopaedics and Related Research ® neither advocates nor endorses the use of any treatment, drug, or device. Readers are encouraged to always seek additional information, including FDA-approval status, of any drug or device prior to clinical use.

Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

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Karlsson, M.K., Magnusson, H., Cöster, M. et al. Patients With Knee Osteoarthritis Have a Phenotype With Higher Bone Mass, Higher Fat Mass, and Lower Lean Body Mass. Clin Orthop Relat Res 473, 258–264 (2015). https://doi.org/10.1007/s11999-014-3973-3

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  • DOI: https://doi.org/10.1007/s11999-014-3973-3

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