Distribution of Bone Mineral Density at the Proximal Tibia in Knee Osteoarthritis

Abstract

One hundred and thirteen knees with osteoarthritis (OA) were studied to assess the distribution of bone mineral density (BMD) in the proximal tibia and the potential relation between osteoarthritis and osteoporosis in evaluating hip BMD. All patients had severe knee pain and were diagnosed with Kellgren and Lawrence grade IV osteoarthritis. According to the magnitude of the axial deformity, four categories were created: varus>10 degrees ( 28.3%), varus 4-10 degrees (38.9%), aligned 180 +/- 3 degrees (13.3%), and valgus>4 degrees (19.5%). For each category, the medial and lateral proximal tibial density were assessed. BMD was measured at the femoral neck and at 14 regions of interest (ROI) in the proximal part of the tibia using dual X-ray absorptiometry. Based on the femoral neck BMD, patients were classified according to the World Health Organization (WHO) definition of osteoporosis. The mean knee BMD was positively correlated with the hip BMD value (knee BMD m = 0.38 + 0.73 x hip BMD, r = 0.60, P<0.001). The knee BMD distribution of the 113 patients was negatively correlated with the axial deformity (BMD MT-LT = 5.15 - 0.027 x HKA, r = 0.77, P<0.0001). In the varus deformity, BMD of the medial side was higher than that of the lateral side with an important asymmetry (0.587 g/cm2). This asymmetry was also found in the valgus deformity for the lateral side but was less important (-0.112 g/cm2). With equal deformity, the asymmetry of BMD was higher in varus deformity (0.587 g/cm2) than in valgus deformity (-0.112 g/cm2). Asymmetry of the knee BMD distribution revealed that progression of the deformity (either varus or valgus) with joint space narrowing led to an increase in the medio-lateral difference of the proximal tibia density. Lesser severity of Kellgren and Lawrence grades may reveal different results. Twenty patients with osteoporosis developed knee osteoarthritis (OA) and the relation between osteoporosis and knee OA remains unclear.

Are bone losers distinguishable from bone formers in a skeletal series? Implications for adult age at death assessment methods

“…Indeed, in several studies (Hochberg et al, 2004;Iwamoto et al, 2002;Hulet et al, 2002;Schneider et al, 2002), patients with low bone density also had osteoarthritis. Dequeker et al (2003) interpreted this fact as an increased bone loss due to local disability in relation to the joint affected by osteoarthritis.…”

“…But radiogrammetry on the second metacarpal is proved to be a relevant diagnostic tool in osteoporosis (Boonen et al, 2005;Crespo et al, 1998;Haara et al, 2006) and loss of cortical bone plays an important role in increasing bone fragility (Boyce and Bloebaum, 1993). Besides, some studies using DXA (Drees et al, 2005a, b;Hochberg et al, 1991Hochberg et al, , 1994Hochberg et al, , 1995Hochberg et al, , 2004Hulet et al, 2002;Kalichman et al, 2002;Ohtsuka et al, 2002;Schneider et al, 2002) could not confirm the inverse relationship between osteoarthritis and osteoporosis.…”

“…Generally, the samples were not randomized in the majority of the studies. For some investigations, the subjects were selected because they showed severe osteoarthritis (Hulet et al, 2002). In other studies, the sample was constituted of volunteers (Hochberg et al, 1991(Hochberg et al, , 1994(Hochberg et al, , 2004 or was selected from a geriatric hospital (Bischoff et al, 2000).…”

Use of non-degenerate human osteochondral tissue and confocal laser scanning microscopy for the study of chondrocyte death at cartilage surgery

“…Furthermore osteoarthritis of the knee tends to affect the medial compartment preferentially to the lateral (Fig. 2) i.e., a varus deformity is more common than a valgus one (Hulet et al, 2002). Knee arthroplasty involves jig-based cuts of the distal femur and it is desirable to site the femoral component in slight external rotation with respect to the transepicondylar axis (Engh, 2000;Scuderi and Insall, 2000).…”

Variability of mineral bone density and some genetic markers in knee osteoarthritis

“…Оказалось, что увеличение МПКТ в меди альном отделе большеберцовой кости связано с сужением сустав ной щели с латеральной стороны, а увеличение МПКТ с лате ральной стороны -с сужением в медиальном отделе. У 20 паци ентов с гонартрозом локально обнаружен ОП [18].…”