Relationship of Bone Mineral Density to Progression of Knee Osteoarthritis

Abstract

Objective We sought to evaluate the longitudinal relationship of bone mineral density (BMD) and its change to knee osteoarthritis (OA) progression measured by cartilage outcomes. Methods We used observational cohort data from the Vitamin D for Knee Osteoarthritis trial. We obtained bilateral femoral neck BMDs as well as knee MRIs in each subject at baseline and subsequently at 12 and 24 months. We measured change in total cartilage volume, tibial and femoral cartilage thickness by manual cartilage segmentation of two sequential knee MRIs in each subject. Multivariable linear regression models were used to examine the associations of baseline BMD and BMD change with the cartilage outcomes, adjusting for baseline age, gender, BMI, malalignment and vitamin D treatment. We validated model fit and assumptions. Results 127 subjects were eligible for analysis. Longitudinal BMD loss was associated with loss of cartilage volume (β=1.25 per 0.1g/cm2, p=0.02) and tibial cartilage thickness (β=0.028, p=0.03). BMD loss of a magnitude greater than least significant change (≤ −4.7%) was associated with 1.02% cartilage volume loss per year (p=0.005), 0.014mm femoral cartilage thickness loss (p=0.04) and 0.021mm tibial cartilage thickness loss per year (p=0.009). There were no significant associations between baseline BMD and any of the cartilage outcomes. Conclusions Longitudinal BMD loss is associated with progressive cartilage loss in knees with OA. Further work to clarify the basis of this relationship could uncover novel therapeutic targets for knee OA.

Combined Effect of Bilateral Ovariectomy and Anterior Cruciate Ligament Transection With Medial Meniscectomy on the Development of Osteoarthritis Model

“…These results are in agreement with a previous study, reporting a decrease in periarticular subchondral BMD in mild OA patients [23]. In addition, Lee et al [24] reported that BMD loss was associated with progressive cartilage loss in knees with OA. Overall, it is inferred that OVX-induced osteoporosis and ACLT with MM-induced cartilage damage led to BMD decrease.…”

The relationship between smoking and knee osteoarthritis in the Osteoarthritis Initiative

“…In a clinical trial of 42 surgical patients with pre-arthritic cartilage lesions, smoking was associated with worse cartilage outcomes due to inhibition of important mediators of cartilage metabolism, IGF-1 and bFGF 41 . Smokers are also at risk for reduced bone density 42 and a 2013 study of radiographcially confirmed knee OA patients (K-L grade ≥2) found that longitudinal bone mineral density loss was associated with progressive knee cartilage loss 43 . Susceptibility to knee OA may be genetic 44 and in one study an association was found between smoking and knee cartilage loss among those with a family history of knee OA while controls (smoking with no family history of knee OA) had no such association 8 .…”

Chondroprotective effects of the combination chondroitin sulfate-glucosamine in a model of osteoarthritis induced by anterior cruciate ligament transection in ovariectomised rats

“…Although an inverse relationship between OA and osteoporosis has been suggested (reviewed in [11]), different reports indicate that osteopenia and osteoporosis occur in a significant proportion of patients with severe knee or hip OA [12] and longitudinal bone mineral density loss, at a site remote from the knee, is associated with progressive loss of cartilage in OA knees [13]. Several studies have also shown that changes in bone can be detected early in the development of OA with osteoporosis subjacent to the subchondral sclerosis area [14] and within the tibiae of patients with knee OA [15].…”