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07-05-2013 | Original Article

Discrepancy in bone mineral densities at different skeletal sites in hip osteoarthritis patients

Authors: Kunihiko Okano, Masako Ito, Kiyoshi Aoyagi, Makoto Osaki, Hiroshi Enomoto, Kazumasa Yamaguchi

Published in: Modern Rheumatology

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Abstract

Objective

Increased femoral neck bone mineral density (BMD) in a hip with osteoarthritis (OA) has been previously reported, however, it is possible that increased BMD at sites other than the hip joint is influenced by the disease process of OA. Therefore, we measured BMD at locations different from the hip joint and determined whether higher BMD was also observed at these different skeletal sites in hip OA patients.

Methods

We measured BMD in 68 women (average age 61.0 years) scheduled to undergo total hip arthroplasty for end-stage OA and 100 healthy women (average age 60.9 years) as age-matched controls. BMD at the lumbar spine, radius, and calcaneus was measured by dual-energy X-ray absorptiometry (DXA). Moreover, we measured speed of sound (SOS), broadband ultrasound attenuation (BUA), and stiffness index of the calcaneus by quantitative ultrasonography (QUS).

Results

BMD obtained by DXA at the lumbar spine and radius was significantly higher in hip OA patients than in controls. However, at the calcaneus, no significant differences were observed between the groups in BMD obtained by DXA. SOS, BUA, and stiffness index obtained by QUS were significantly lower in the OA group than in controls.

Conclusion

Higher BMDs of the spine and radius suggest that the incidence of osteoporosis is inversely associated with the incidence of OA. However, it remains unclear whether lack of difference in BMD and lower SOS, BUA, and stiffness index of the calcaneus in the OA group was secondary to the effect walking disturbance resulting from hip pain. Our data suggest that hip OA patients have higher BMD than healthy women, and that inactivity or immobilization caused by hip OA may reduce BMD in the lower limb.
Literature
1.
go back to reference van Saase JL, van Romunde LK, Cats A, Vandenbroucke JP, Valkenburg HA. Epidemiology of osteoarthritis: Zoetermeer survey. Comparison of radiological osteoarthritis in a Dutch population with that in 10 other populations. Ann Rheum Dis. 1989;48:271–80.PubMedCrossRef van Saase JL, van Romunde LK, Cats A, Vandenbroucke JP, Valkenburg HA. Epidemiology of osteoarthritis: Zoetermeer survey. Comparison of radiological osteoarthritis in a Dutch population with that in 10 other populations. Ann Rheum Dis. 1989;48:271–80.PubMedCrossRef
2.
go back to reference Maggi S, Kelsey JL, Litvak J, Heyse SP. Incidence of hip fractures in the elderly: a cross-national analysis. Osteoporos Int. 1991;1:232–41.PubMedCrossRef Maggi S, Kelsey JL, Litvak J, Heyse SP. Incidence of hip fractures in the elderly: a cross-national analysis. Osteoporos Int. 1991;1:232–41.PubMedCrossRef
3.
go back to reference Sambrook P, Naganathan V. What is the relationship between osteoarthritis and osteoporosis? Baillieres Clin Rheumatol. 1997;11:695–710.PubMedCrossRef Sambrook P, Naganathan V. What is the relationship between osteoarthritis and osteoporosis? Baillieres Clin Rheumatol. 1997;11:695–710.PubMedCrossRef
4.
go back to reference Gotfredsen A, Riis BJ, Christiansen C, Rodbro P. Does a single local absorptiometric bone measurement indicate the overall skeletal status? Implications for osteoporosis and osteoarthritis of the hip. Clin Rheumatol. 1990;9:193–203.PubMedCrossRef Gotfredsen A, Riis BJ, Christiansen C, Rodbro P. Does a single local absorptiometric bone measurement indicate the overall skeletal status? Implications for osteoporosis and osteoarthritis of the hip. Clin Rheumatol. 1990;9:193–203.PubMedCrossRef
5.
go back to reference Nevitt MC, Lane NE, Scott JC, Hochberg MC, Pressman AR, Genant HK, Cummings SR. Radiographic osteoarthritis of the hip and bone mineral density. The Study of Osteoporotic Fractures Research Group. Arthritis Rheum. 1995;38:907–16.PubMedCrossRef Nevitt MC, Lane NE, Scott JC, Hochberg MC, Pressman AR, Genant HK, Cummings SR. Radiographic osteoarthritis of the hip and bone mineral density. The Study of Osteoporotic Fractures Research Group. Arthritis Rheum. 1995;38:907–16.PubMedCrossRef
6.
go back to reference Burger H, van Daele PL, Odding E, Valkenburg HA, Hofman A, Grobbee DE, Schutte HE, Birkenhager JC, Pols HA. Association of radiographically evident osteoarthritis with higher bone mineral density and increased bone loss with age. The Rotterdam study. Arthritis Rheum. 1996;39:81–6.PubMedCrossRef Burger H, van Daele PL, Odding E, Valkenburg HA, Hofman A, Grobbee DE, Schutte HE, Birkenhager JC, Pols HA. Association of radiographically evident osteoarthritis with higher bone mineral density and increased bone loss with age. The Rotterdam study. Arthritis Rheum. 1996;39:81–6.PubMedCrossRef
7.
go back to reference Bruno RJ, Sauer PA, Rosenberg AG, Block J, Sumner DR. The pattern of bone mineral density in the proximal femur and radiographic signs of early joint degeneration. J Rheumatol. 1999;26:636–40.PubMed Bruno RJ, Sauer PA, Rosenberg AG, Block J, Sumner DR. The pattern of bone mineral density in the proximal femur and radiographic signs of early joint degeneration. J Rheumatol. 1999;26:636–40.PubMed
8.
go back to reference Antoniades L, MacGregor AJ, Matson M, Spector TD. A cotwin control study of the relationship between hip osteoarthritis and bone mineral density. Arthritis Rheum. 2000;43:1450–5.PubMedCrossRef Antoniades L, MacGregor AJ, Matson M, Spector TD. A cotwin control study of the relationship between hip osteoarthritis and bone mineral density. Arthritis Rheum. 2000;43:1450–5.PubMedCrossRef
9.
go back to reference Jordan GR, Loveridge N, Bell KL, Power J, Dickson GR, Vedi S, Rushton N, Clarke MT, Reeve J. Increased femoral neck cancellous bone and connectivity in coxarthrosis (hip osteoarthritis). Bone. 2003;32:86–95.PubMedCrossRef Jordan GR, Loveridge N, Bell KL, Power J, Dickson GR, Vedi S, Rushton N, Clarke MT, Reeve J. Increased femoral neck cancellous bone and connectivity in coxarthrosis (hip osteoarthritis). Bone. 2003;32:86–95.PubMedCrossRef
10.
go back to reference Makinen TJ, Alm JJ, Laine H, Svedstrom E, Aro HT. The incidence of osteopenia and osteoporosis in women with hip osteoarthritis scheduled for cementless total joint replacement. Bone. 2007;40:1041–7.PubMedCrossRef Makinen TJ, Alm JJ, Laine H, Svedstrom E, Aro HT. The incidence of osteopenia and osteoporosis in women with hip osteoarthritis scheduled for cementless total joint replacement. Bone. 2007;40:1041–7.PubMedCrossRef
11.
go back to reference Cushnaghan J, Dieppe P. Study of 500 patients with limb joint osteoarthritis. I. Analysis by age, sex, and distribution of symptomatic joint sites. Ann Rheum Dis. 1991;50:8–13.PubMedCrossRef Cushnaghan J, Dieppe P. Study of 500 patients with limb joint osteoarthritis. I. Analysis by age, sex, and distribution of symptomatic joint sites. Ann Rheum Dis. 1991;50:8–13.PubMedCrossRef
12.
go back to reference Crowe JF, Mani VJ, Ranawat CS. Total hip replacement in congenital dislocation and dysplasia of the hip. J Bone Joint Surg Am. 1979;61:15–23.PubMed Crowe JF, Mani VJ, Ranawat CS. Total hip replacement in congenital dislocation and dysplasia of the hip. J Bone Joint Surg Am. 1979;61:15–23.PubMed
13.
go back to reference Nakamura S, Ninomiya S, Takatori Y, Morimoto S, Umeyama T. Long-term outcome of rotational acetabular osteotomy: 145 hips followed for 10–23 years. Acta Orthop Scand. 1998;69:259–65.PubMedCrossRef Nakamura S, Ninomiya S, Takatori Y, Morimoto S, Umeyama T. Long-term outcome of rotational acetabular osteotomy: 145 hips followed for 10–23 years. Acta Orthop Scand. 1998;69:259–65.PubMedCrossRef
14.
go back to reference Merle d’Aubigne R, Postel M. Functional results of hip arthroplasty with acrylic prosthesis. J Bone Joint Surg Am. 1954;36-A:451–75. Merle d’Aubigne R, Postel M. Functional results of hip arthroplasty with acrylic prosthesis. J Bone Joint Surg Am. 1954;36-A:451–75.
15.
go back to reference Finsen V, Benum P. Osteopenia after ankle fractures. The influence of early weight bearing and muscle activity. Clin Orthop Relat Res. 1989;245:261–8.PubMed Finsen V, Benum P. Osteopenia after ankle fractures. The influence of early weight bearing and muscle activity. Clin Orthop Relat Res. 1989;245:261–8.PubMed
16.
go back to reference Ito M, Matsumoto T, Enomoto H, Tsurusaki K, Hayashi K. Effect of nonweightbearing on tibial bone density measured by QCT in patients with hip surgery. J Bone Miner Metab. 1999;17:45–50.PubMedCrossRef Ito M, Matsumoto T, Enomoto H, Tsurusaki K, Hayashi K. Effect of nonweightbearing on tibial bone density measured by QCT in patients with hip surgery. J Bone Miner Metab. 1999;17:45–50.PubMedCrossRef
17.
go back to reference Njeh CF, Fuerst T, Diessel E, Genant HK. Is quantitative ultrasound dependent on bone structure? A reflection. Osteoporos Int. 2001;12:1–15.PubMed Njeh CF, Fuerst T, Diessel E, Genant HK. Is quantitative ultrasound dependent on bone structure? A reflection. Osteoporos Int. 2001;12:1–15.PubMed
18.
go back to reference Landin-Wilhelmsen K, Johansson S, Rosengren A, Dotevall A, Lappas G, Bengtsson BA, Wilhelmsen L. Calcaneal ultrasound measurements are determined by age and physical activity. Studies in two Swedish random population samples. J Intern Med. 2000;247:269–78.PubMedCrossRef Landin-Wilhelmsen K, Johansson S, Rosengren A, Dotevall A, Lappas G, Bengtsson BA, Wilhelmsen L. Calcaneal ultrasound measurements are determined by age and physical activity. Studies in two Swedish random population samples. J Intern Med. 2000;247:269–78.PubMedCrossRef
19.
go back to reference Yanagimoto Y, Oshida Y, Sato Y. Effects of walking on bone quality as determined by ultrasound in the elderly. Scand J Med Sci Sports. 2000;10:103–8.PubMedCrossRef Yanagimoto Y, Oshida Y, Sato Y. Effects of walking on bone quality as determined by ultrasound in the elderly. Scand J Med Sci Sports. 2000;10:103–8.PubMedCrossRef
20.
go back to reference Messenger N, Scott S, McNaught-Davis P. Can the effects of exercise on bone quality be detected using the CUBA clinical ultrasound system? Br J Sports Med. 1998;32:162–6.PubMedCrossRef Messenger N, Scott S, McNaught-Davis P. Can the effects of exercise on bone quality be detected using the CUBA clinical ultrasound system? Br J Sports Med. 1998;32:162–6.PubMedCrossRef
21.
go back to reference Laabes EP, Vanderjagt DJ, Obadofin MO, Sendeht AJ, Glew RH. Assessment of the bone quality of black female athletes using quantitative ultrasound. J Sports Med Phys Fit. 2008;48:502–8. Laabes EP, Vanderjagt DJ, Obadofin MO, Sendeht AJ, Glew RH. Assessment of the bone quality of black female athletes using quantitative ultrasound. J Sports Med Phys Fit. 2008;48:502–8.
22.
go back to reference Stewart A, Black A, Robins SP, Reid DM. Bone density and bone turnover in patients with osteoarthritis and osteoporosis. J Rheumatol. 1999;26:622–6.PubMed Stewart A, Black A, Robins SP, Reid DM. Bone density and bone turnover in patients with osteoarthritis and osteoporosis. J Rheumatol. 1999;26:622–6.PubMed
23.
go back to reference Arokoski JP, Arokoski MH, Jurvelin JS, Helminen HJ, Niemitukia LH, Kroger H. Increased bone mineral content and bone size in the femoral neck of men with hip osteoarthritis. Ann Rheum Dis. 2002;61:145–50.PubMedCrossRef Arokoski JP, Arokoski MH, Jurvelin JS, Helminen HJ, Niemitukia LH, Kroger H. Increased bone mineral content and bone size in the femoral neck of men with hip osteoarthritis. Ann Rheum Dis. 2002;61:145–50.PubMedCrossRef
Metadata
Title
Discrepancy in bone mineral densities at different skeletal sites in hip osteoarthritis patients
Authors
Kunihiko Okano
Masako Ito
Kiyoshi Aoyagi
Makoto Osaki
Hiroshi Enomoto
Kazumasa Yamaguchi
Publication date
07-05-2013
Publisher
Springer Japan
Published in
Modern Rheumatology
Print ISSN: 1439-7595
Electronic ISSN: 1439-7609
DOI
https://doi.org/10.1007/s10165-013-0893-0