The influence of osteoporosis on varus osteoarthritis of the knee

Terauchi, Masanori; Shirakura, Kenji; Katayama, Masayoshi; Higuchi, Hirofumi; Takagishi, Kenji

doi:10.1302/0301-620x.80b3.0800432

Cited by 14 publications

(14 citation statements)

References 28 publications

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“…Some patients with low bone mass could, therefore, be classified as having radiological grade 4 rather than grade 3. These suggestions are consistent with evidence reported by Terauchi et al 23 that there are two types of varus OA of the knee: one caused by low bone mass, and the other associated with high bone mass. In the present study, because the mean BMD in grade 4 in the OA group was higher than that in the control group, it is possible that the number of patients with radiological grade 4 with high BMD may be much greater than the number with low BMD.…”

Section: Discussionsupporting

confidence: 93%

“…1,17,21 Recently, however, Terauchi et al 23 have reported varus OA of the knee caused by low bone mass, in which the varus deformity originated from trabecular microfractures in the proximal tibia and, consequently, increased stress on the articular cartilage. Furthermore, the Baltimore study of aging showed that although men, but not women, with definite knee OA had significantly greater radial bone mass and size, subjects with knee OA did not have significantly higher bone mineral density (BMD) in the upper extremity.…”

mentioning

confidence: 99%

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Forearm bone mineral density in postmenopausal women with osteoarthritis of the knee

Iwamoto

Takeda

Ichimura

2002

Journal of Orthopaedic Science

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Section: Discussionsupporting

confidence: 93%

mentioning

confidence: 99%

Forearm bone mineral density in postmenopausal women with osteoarthritis of the knee

Iwamoto

Takeda

Ichimura

2002

Journal of Orthopaedic Science

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“…These findings suggest that the participants likely had mild to moderate disease severity. It is important to note, though, that medial joint space narrowing does not always result in varus alignment but rather a change in the angle between the femoral condyles and the femoral shaft and/or between the tibial plateau and tibial shaft (44). Some limitations of this study must be considered.…”

mentioning

confidence: 90%

Determinants of self efficacy for physical tasks in people with knee osteoarthritis

Maly¹,

Costigan²,

Olney³

2006

Arthritis & Rheumatism

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Objective. Self efficacy, the confidence an individual has to perform a task, is an important determinant of physical performance in individuals with knee osteoarthritis (OA). The purpose of this study was to determine what personal, pathophysiologic, and impairment factors relate to self efficacy for physical tasks in community-dwelling adults with knee OA. Methods. Fifty-four persons with radiographically confirmed knee OA (mean ؎ SD age 68.3 ؎ 8.7 years, range 50 -87 years) participated. The Functional Self-Efficacy subscale of the Arthritis Self-Efficacy Scale was the dependent measure. Independent measures included age, education, scores from the Center for Epidemiologic Studies Depression and State-Trait Anxiety Inventory questionnaires, medial joint space and varus/valgus tibiofemoral angle from radiographs, body mass index, and isokinetic quadriceps and hamstrings strength. Knee pain and stiffness, assessed using the Western Ontario and McMaster Universities Osteoarthritis Index, were independent measures. Results. Fifty-one percent of the variance of Functional Self Efficacy was explained by knee stiffness, hamstrings strength, age, and depression scores. Pain, education, anxiety, radiographic joint space, and body weight did not significantly contribute to the variance in Functional Self-Efficacy scores. Substituting quadriceps strength for hamstrings strength resulted in a regression model that included only stiffness, age, and depression, which explained nearly as much variance as the original model. Conclusion. Self efficacy for physical tasks is related to the sensation of stiffness, hamstrings strength, age, and level of depressive symptoms in persons with knee OA. Clinicians and researchers could consider these variables when assessing the level of self efficacy for physical tasks in persons with knee OA.

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“…This finding is supported by the finding that during walking, approximately 70% of total load is typically transmitted through the medial compartment in the normal knee joint (Hurwitz et al 1998). Degenerative joint disease, osteoarthrosis (OA) when severe, leads to relative sclerosis beneath the loaded condyle and relative porosis beneath the unloaded condyle, with the strongest bone being found on the concave side of the deformity (Terauchi et al 1998). In previous studies, the tibial BMD of the medial compartment has been shown to be significantly higher than that of the lateral compartment, both in mild and severe OA (Akamatsu et al 1997, Wada et al 2001.…”

mentioning

confidence: 92%

Periprosthetic tibial bone mineral density changes after total knee arthroplastyOne-year follow-up study of 69 patients

Soininvaara

Miettinen

Jurvelin

et al. 2004

Acta Orthopaedica Scandinavica

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Background The critical structure supporting the prosthetic components in total knee arthroplasty (TKA) is tibial trabecular bone. The quality of tibial bone can be evaluated by bone mineral density (BMD) measurements.Patients and methods We prospectively measured changes in BMD in the proximal tibia after cemented TKA in osteoarthrotic knees. 69 patients were scanned by dual-energy X-ray absorptiometry (DXA) within a week after surgery, and after 3, 6 and 12 months.Results At baseline, the medial region of interest (ROI) BMD was higher in the varus knees than in the valgus aligned knees (p = 0.02). The medial metaphyseal ROI showed a decrease in BMD during the follow-up in preoperatively varus knee joints (p < 0.001). In preoperatively valgus knees, there was a slight increase in medial compartment BMD which was not significant (p = 0.2). Alignment correction in both groups showed bone remodeling giving similar medial and lateral BMD values, suggesting that the bone became equally strong in both compartments of the metaphysis. There was no association between increasing American Knee Society (AKS) scores and bone remodeling.Interpretation We suggest that this remodeling is caused by postoperative changes in tibial loading. Our results support the clinical importance of recreating proper valgus alignment of the knee joint in the TKA operation, thus possibly providing better conditions for longevity of the tibial component.

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The influence of osteoporosis on varus osteoarthritis of the knee

Cited by 14 publications

References 28 publications

Forearm bone mineral density in postmenopausal women with osteoarthritis of the knee

Forearm bone mineral density in postmenopausal women with osteoarthritis of the knee

Determinants of self efficacy for physical tasks in people with knee osteoarthritis

Periprosthetic tibial bone mineral density changes after total knee arthroplastyOne-year follow-up study of 69 patients

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