Relationship Between Low Bone Mineral Density and Varus Deformity in Postmenopausal Women with Knee Osteoarthritis

Akamatsu, Yasushi; Mitsugi, Naoto; Taki, Naoya; Takeuchi, Ryouhei; Saito, T.

doi:10.3899/jrheum.080699

Cited by 19 publications

(21 citation statements)

References 25 publications

(21 reference statements)

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“…In addition, similar to the case of the femoral neck, the SONK group had significantly lower BMDs at the lateral femoral and lateral tibial condyles than the OA group. The lateral condyle BMDs represent the BMD of the ipsilateral lower extremity in all of the knee condyles, as we found in a previous study (Akamatsu et al 2009). These findings therefore suggest that recent onset of SONK has an association with low BMD in women over 60 years.…”

Section: Discussionsupporting

confidence: 56%

Low bone mineral density is associated with the onset of spontaneous osteonecrosis of the knee

et al. 2012

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Background and purposeThe primary event preceding the onset of symptoms in spontaneous osteonecrosis in the medial femoral condyle (SONK) may be a subchondral insufficiency fracture, which may be associated with underlying low bone mineral density (BMD). However, the pathogenesis of SONK is considered to be multifactorial. Women over 60 years of age tend to have higher incidence of SONK and low BMD. We investigated whether there may be an association between low BMD and SONK in women who are more than 60 years old.MethodsWe compared the BMD of 26 women with SONK within 3 months after the onset of symptoms to that of 26 control women with medial knee osteoarthritis (OA). All the SONK patients had typical clinical presentations and met specified criteria on MRI. The BMDs measured at the lumbar spine, ipsilateral femoral neck, and knee condyles and the ratios of medial condyle BMD to lateral condyle BMD (medial-lateral ratios) in the femur and tibia were compared between the two groups. The medial-lateral ratios were used as parameters for comparisons of the BMDs at both condyles.ResultsThe mean femoral neck, lateral femoral condyle, and lateral tibial condyle BMDs were between x% and y% lower in the SONK patients than in the OA patients (p < 0.001). The mean femoral and tibial medial-lateral ratios were statistically significantly higher in the SONK patients than in the OA patients.InterpretationA proportion of women over 60 years of age have low BMD that progresses rapidly after menopause and can precipitate a microfracture. These findings support the subchondral insufficiency fracture theory for the onset of SONK based on low BMD.

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Section: Discussionsupporting

confidence: 56%

Low bone mineral density is associated with the onset of spontaneous osteonecrosis of the knee

et al. 2012

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“…The decreases in lateral femoral and tibial condyle BMDs with advancing age could be attributed to general osteoporosis. We stated in a previous study that lateral tibial condyle BMD is probably a better reflection of BMD at the knee than medial tibial condyle BMD (38); furthermore, the decreased lateral condyle BMDs with age may represent a postmenopausal decrease in the general BMD. Alternatively, the finding that the medial condyle BMDs did not decrease with age might result in subchondral bone sclerosis, followed by the progression of medial knee OA with age.…”

Section: Discussionmentioning

confidence: 87%

“…At later stages, after the subchondral bone has been exposed, deformation occurs as a result of subchondral bone plate microfractures, suggesting that changes in the subchondral bone may play a larger role than that played by changes in the underlying trabeculae (3). Moreover, the association between varus inclination of the tibial plateau and low BMD suggests that microfractures may occur before the eburnation of the subchondral bone (38, 44). In addition, previous experimental data have revealed that edema of the medial bone marrow, which was identified on MRI, is associated with varus deformities in patients with medial knee OA (45), but it is unknown whether edema of the bone marrow affects structural changes.…”

Section: Discussionmentioning

confidence: 99%

Medial versus lateral condyle bone mineral density ratios in a cross‐sectional study: A potential marker for medial knee osteoarthritis severity

Akamatsu¹,

Mitsugi²,

Taki³

et al. 2012

Arthritis Care & Research

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Objective. To assess the association of bone mineral density (BMD) of the femoral and tibial condyles with knee pain and disease severity in women with symptomatic medial knee osteoarthritis (OA). Methods. We enrolled 192 women (ages 41-90 years) between April 2007 and March 2011. The subjects were divided into 2 groups according to joint space narrowing (JSN) on weight-bearing radiographs. BMD of the lumbar spine, proximal femur, and knee condyles was measured. Medial and lateral condyle BMDs of the femur and tibia as well as the medial versus lateral condyle BMD ratios were measured. Results. Mean medial condyle BMDs, medial versus lateral condyle BMD ratios, and visual analog scale (VAS) pain in both the femur and the tibia were higher in the obliteration group compared with the narrowing group (P < 0.001 for all). A significant positive correlation was observed between the femoral and tibial condyles in the following parameters: medial condyle BMDs, lateral condyle BMDs, and medial versus lateral condyle BMD ratios (r ‫؍‬ 0.791-0.844). In both the femur and the tibia, medial versus lateral condyle BMD ratios had significant positive correlations with femorotibial angle, medial osteophytes, lateral osteophytes, medial JSN, and VAS pain, and had significant negative correlations with the Knee Society pain and function scores. Conclusion. Although this study was a cross-sectional study, the femoral and tibial medial versus lateral condyle BMD ratios increased with more severe knee pain and might be a potential marker for monitoring disease severity in women with symptomatic medial knee OA.

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“…Osteoarthritis (OA) is the most common joint disease and is characterized by a progressive loss of cartilage, changes in the subchondral bone, inactivity-related stiffness, and chronic pain [1,2,3,4]. Although pain is the predominant clinical feature of OA, the specific source and molecular events responsible for originating the pain from the OA joint are not yet completely understood [5].…”

Section: Introductionmentioning

confidence: 99%

Antinociceptive Efficacy of Retigabine in the Monosodium Lodoacetate Rat Model for Osteoarthritis Pain

Han

Wang

et al. 2015

Pharmacology

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Background: The goal of pharmacological osteoarthritis (OA) treatments is to reduce pain and thus increase patient joint function and quality of life. Retigabine, a potent Kv7/M channel activator, shows analgesic efficacy in animal models of chronic inflammatory and neuropathic pain. We hypothesized that retigabine may also mitigate OA pain. To determine the effects of retigabine on pain behavior associated with monosodium iodoacetate (MIA)-induced OA. Methods: The OA model was established with an intra-articular injection of MIA through the right patellar ligament, animals were treated with retigabine, and pain-related behaviors were assessed. Results: Retigabine significantly increased the mechanical threshold and prolonged the withdrawal latency of OA rats at 3-14 days. Retigabine also increased the mechanical threshold and prolonged the withdrawal latency of OA pain in a dose-dependent manner, with the strongest antinociceptive effect occurring at 60 min. The antinociceptive effects of retigabine were fully antagonized by the Kv7/M channel blocker XE991. Conclusion: Retigabine showed antinociceptive effects for OA pain in the MIA model at different times during pain development. Retigabine may be an alternative therapeutic treatment for OA.

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Relationship Between Low Bone Mineral Density and Varus Deformity in Postmenopausal Women with Knee Osteoarthritis

Abstract: Varus inclination of the tibial plateau was significantly more severe in the femorotibial angle tertile 3 group, and in patients with lower BMD in the ipsilateral lower limb. Varus knee OA may result not only from cartilage loss but also from structural changes of the bone.

Cited by 19 publications

References 25 publications

Low bone mineral density is associated with the onset of spontaneous osteonecrosis of the knee

Low bone mineral density is associated with the onset of spontaneous osteonecrosis of the knee

Medial versus lateral condyle bone mineral density ratios in a cross‐sectional study: A potential marker for medial knee osteoarthritis severity

Antinociceptive Efficacy of Retigabine in the Monosodium Lodoacetate Rat Model for Osteoarthritis Pain

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