The incidence of osteopenia and osteoporosis in women with hip osteoarthritis scheduled for cementless total joint replacement

Mäkinen, Tuula; Alm, Jessica J.; Laine, Hanna; Svedström, Erkki; Aro, Hannu T.

doi:10.1016/j.bone.2006.11.013

Cited by 124 publications

(109 citation statements)

References 27 publications

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“…This process may alter bone mineral metabolism and lead to progression of knee OA through development of osteopenia or exacerbation of osteoporosis [8]. A higher than expected rate of vitamin D deficiency, as has been reported in OA, indicates that these patients are at higher risk of disease progression [11,12]. Hence, knowledge of the serum status of 25-OHD may provide additional information for recognising patients at risk of progression.…”

Section: Introductionmentioning

confidence: 99%

Association between serum vitamin D deficiency and knee osteoarthritis

Heidari

Hajian‐Tilaki

2010

International Orthopaedics (SICOT)

108

100

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Background Insufficient levels of serum 25-hydroxyvitamin D (25-OHD) influence the knee joint cartilage and lead to development and progression of knee osteoarthritis (OA). The purpose of this study was to determine the status of serum 25-OHD levels in patients with knee OA compared with controls. Methods A total of 148 patients with knee OA and 150 controls were studied. Serum 25-OHD was measured by the ELISA method and concentrations<20 ng/ml were considered as deficient levels. Mann-Whitney U test was used for comparisons of means and logistic regression analysis with calculation of odds ratio (OR) was applied to determine association. Results The mean ages of patients and controls were 60.2± 12.9 and 60.1±10.2 years, respectively (P=0.23). In the entire population the mean serum 25-OHD in OA patients was not significantly lower than controls (P=0.28), but in subgroup analysis the mean 25-OHD in OA patients aged <60 years was significantly lower than controls (23.8±18.8 vs. 34.5.±29.6 ng/ml, P=0.01). In this age group knee OA was significantly associated with serum 25-OHD deficiency which remained significant after adjusting for age and sex (adjusted OR=2.26, 95% CI 1.15-4.4, P=0.018). A greater association was observed in patients aged<55 years (OR=2.63, 95% CI 1.16-5.95, P= 0.01); whereas the association between OA and serum 25-OHD deficiency in patients aged ≥60 years did not reach a significant level. Conclusion These findings indicate a significant association between serum 25-OHD deficiency and knee OA in patients aged < 60 years and suggest serum 25-OHD measurement in any patient with symptoms suggestive of knee OA particularly at the initial stage of disease.

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Section: Introductionmentioning

confidence: 99%

Association between serum vitamin D deficiency and knee osteoarthritis

Heidari

Hajian‐Tilaki

2010

International Orthopaedics (SICOT)

108

100

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“…Table 3 shows the hip and the spine of the patients preoperatively. The bone mineral density at the hip was 0.5460.08 g/ cm 2 and spine was 0.73 6 0.1 with T score at the hip and spine of À2.23 6 0.44 and À2.61 6 0.45, respectively. The bone mineral density of the tibial cut was 0.356 6 0.03 g/cm 2 (P , 0.001) and T score was À6.58 6 2.87 (P , 0.001).…”

Section: Resultsmentioning

confidence: 95%

“…It is also known for some time that it is difficult to assess the trabecular bone by DXA, and it mainly assesses the cortical bone more than the trabecular bone. Second, the size of bone assessed by DXA influences areal BMD (g/cm 2 ) and thereby gives a positive reading compared with pQCT, which is not influenced by the size and measures volumetric BMD. Thus, it gives a more accurate reading that will help in the correct therapeutic interventions in osteoporosis.…”

Section: Discussionmentioning

confidence: 99%

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High-Resolution Peripheral Quantitative Computed Tomography (HR-PQCT) and Dual Energy X-Ray Absorptiometry (DXA) Measurements of Proximal Tibia in Patients Undergoing Total Knee Arthroplasty

Sadat-Ali

Al-Omran

2016

International Surgery

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The aim of the study was to assess bone morphometric indices of the proximal tibia and compare it with bone mineral density (BMD) at hip and lumbar spine and compare with the pQCT. Fifty consecutive patients who underwent total knee arthroplasty (TKA) had a dual energy X-ray absorptiometry (DXA) scan of the upper femur and lumbar spine. Upper tibial cuts were harvested from the tibial condyles and a DXA of tibial cuts was done during TKA. Bone morphometry studies were carried out using HR-pQCT. The bone mineral density at the hip was 0.54 6 0.08 g/cm 2 and spine was 0.73 6 0.1 with a T score at the hip À2.23 6 0.44 and spine À2.61 6 0.45. The bone mineral density of the tibial cut was 0.356 6 0.03 g/cm 2 (P , 0.001) and T score was À6.58 6 2.87 (P , 0.001). The average bone volume (BV) was 115.27 6 40.45 mm 3 , trabecular number (Tb.N) was 1.45 6 0.32 (1.009-2.37) and trabecular thickness (Tb.Th) was 0.181 6 0.03 mm (0.111-0.268). The mean bone mineral density measured was 206.24 6 50.58 mg HA/ccm. This study shows that there is highly significant difference between BMD measured by DXA and pQCT, and that bone morphometric analysis indicates that there is marked decrease in the mechanical properties of the bone in the proximal tibia due to knee Osteoarthritis and Osteoporosis indicating poor bone architecture and quality.

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“…The co-existence of osteoporosis and osteoarthritis remains obscure [18], but it is clear that particularly in developed countries, the obese and osteoporotic populations are increasing in a parallel way [12]; in fact, overweight and obesity contribute to oestrogen hormonal changes and probably contribute to osteoporosis. Furthermore, overweight and obesity promote the early development of osteoarthritis, leading to joint replacement in most patients.…”

Section: Discussionmentioning

confidence: 99%

Outcome of hybrid stem fixation in osteoporotic female patients. A minimum five-year follow-up study

Traina

Tassinari

Pilla

et al. 2008

International Orthopaedics (SICOT)

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In osteoporotic patients cemented stems are usually used to achieve a good primary stability. However, when patients are obese or active the long-term survival of cemented prostheses is questioned. In these patients, a partially-cemented stem with a hybrid fixation could be advantageous. A hybrid stem was retrospectively evaluated at a minimum follow-up of 60 months (mean, 75 months) in 58 osteoporotic women: seventeen with a body mass index (BMI) >30 (obese), 41 with a BMI between 25 and 29.9 (overweight), and an UCLA score for activity level >6. At the latest follow up, the Harris hip score improved from 33.5 points preoperatively to 81.6 points, and the WOMAC score improved significantly. Three stems (4.9%) had an asymptomatic subsidence of less than 2.5 mm; no stem was revised. These results support the use of partially-cemented stems in heavy or active osteoporotic women.Résumé Chez les patients présentant une ostéoporose une pièce fémorale cimentée est habituellement utilisée de façon à avoir une bonne stabilité. Cependant chez certains patients obèses et très actifs la courbe de survie peut, dans ce cas, être altérée. Ces patients ont eu la possibilité d'être opérés avec une prothèse partiellement cimentée, cette fixation hybride pouvant être avantageuse. Matériel et méthode: cette prothèse fémorale hybride a été évaluée de façon rétrospective avec un minimum de suivi de 60 mois (en moyenne 75 mois) chez 58 patients ostéoporotiques,17 femmes présentant un BMI > 30 (obèses), 41 avec un BMI entre 25 et 29,9 (surpoids) et un score UCLA supérieur à 6. Résultats: au dernier suivi le score de Harris a montré une amélioration de 33,5 points en préopératoire à 81,6 points, le score de Womac s'est également amélioré de façon significative. Trois pièces fémorales ont présenté une migration (4,9%) de moins de 2,5 millimètres, aucune révision fémorale n'a été réalisée. En conclusion, ces résultats permettent de penser qu'une prothèse partiellement cimentée hybride est indiquée chez ces patients obèses actifs et présentant une ostéoporose notamment chez la femme.

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The incidence of osteopenia and osteoporosis in women with hip osteoarthritis scheduled for cementless total joint replacement

Cited by 124 publications

References 27 publications

Association between serum vitamin D deficiency and knee osteoarthritis

Association between serum vitamin D deficiency and knee osteoarthritis

High-Resolution Peripheral Quantitative Computed Tomography (HR-PQCT) and Dual Energy X-Ray Absorptiometry (DXA) Measurements of Proximal Tibia in Patients Undergoing Total Knee Arthroplasty

Outcome of hybrid stem fixation in osteoporotic female patients. A minimum five-year follow-up study

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