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Open Access 01-12-2017 | Original Article

Osteoarthritis of the hip joint in elderly patients is most commonly atrophic, with low parameters of acetabular dysplasia and possible involvement of osteoporosis

Authors: Yasuhiro Ishidou, Kanehiro Matsuyama, Daisuke Sakuma, Takao Setoguchi, Satoshi Nagano, Ichiro Kawamura, Shingo Maeda, Setsuro Komiya

Published in: Archives of Osteoporosis | Issue 1/2017

Abstract

Summary

As elderly patients with hip osteoarthritis aged, acetabular dysplasia parameters decreased (Sharp’s angle, acetabular roof obliquity angle, and acetabular head index) and the incidence of the atrophic type increased. Vertebral body fracture was more frequent in the atrophic type, suggesting the involvement of osteoporosis at the onset of hip osteoarthritis.

Introduction

Osteoarthritis (OA) is associated with increased bone formation at a local site. However, excessive bone resorption has also been found to occur in the early stages of OA. Osteoporosis may be involved in the onset of OA in elderly patients. We conducted a cross-sectional radiographic study of patients with hip OA and examined the association between age and factors of acetabular dysplasia (Sharp’s angle, acetabular roof obliquity angle, and acetabular head index) as well as the osteoblastic response to determine the potential involvement of osteoporosis.

Methods

This study included 366 patients (58 men, 308 women) who had undergone total hip arthroplasty for the diagnosis of hip OA. We measured the parameters of acetabular dysplasia using preoperative frontal X-ray images and evaluated each patient according to Bombelli classification of OA (hypertrophic, normotrophic, or atrophic type).

Results

As the patients aged, the parameters of acetabular dysplasia decreased. The incidence of the atrophic type of OA was significantly higher in older patients. Vertebral body fractures were more frequent in the atrophic type than in the other types. Additionally, the index of acetabular dysplasia was lower in the atrophic type. By contrast, the hypertrophic type was present in relatively younger patients and was associated with an increased index of acetabular dysplasia.

Conclusion

In elderly patients with hip OA, the parameters of acetabular dysplasia decreased and the incidence of the atrophic type increased as the patients aged. The frequency of vertebral body fracture was high in patients with the atrophic type, suggesting the involvement of osteoporosis in the onset of hip OA.

Li ZC, Dai LY, Jiang LS, Qiu S (2012) Difference in subchondral cancellous bone between postmenopausal women with hip osteoarthritis and osteoporotic fracture: implication for fatigue microdamage, bone microarchitecture, and biomechanical properties. Arthritis Rheum 64:3955–3962. doi:10.1002/art.34670 CrossRefPubMed

Dequeker J, Aerssens J, Luyten FP (2003) Osteoarthritis and osteoporosis: clinical and research evidence of inverse relationship. Aging Clin Exp Res 15:426–439CrossRefPubMed

Bultink IE, Lems WF (2013) Osteoarthritis and osteoporosis: what is the overlap? Curr Rheumatol Rep 15:328. doi:10.1007/s11926-013-0328-0 CrossRefPubMed

Lories RJ, Luyten FP (2011) The bone-cartilage unit in osteoarthritis. Nat Rev Rheumatol 7:43–49. doi:10.1038/nrrheum.2010.197 CrossRefPubMed

Goldring MB, Goldring SR (2010) Articular cartilage and subchondral bone in the pathogenesis of osteoarthritis. Ann N Y Acad Sci 1192:230–237. doi:10.1111/j.1749-6632.2009.05240.x CrossRefPubMed

Sharma AR, Jagga S, Lee SS, Nam JS (2013) Interplay between cartilage and subchondral bone contributing to pathogenesis of osteoarthritis. Int J Mol Sci 14:19805–19830. doi:10.3390/ijms141019805 CrossRefPubMedPubMedCentral

Findlay DM, Atkins GJ (2014) Osteoblast-chondrocyte interactions in osteoarthritis. Curr Osteoporos Rep 12:127–134. doi:10.1007/s11914-014-0192-5 CrossRefPubMedPubMedCentral

Yuan XL, Meng HY, Wang YC, Peng J, Guo QY, Wang AY, Lu SB (2014) Bone-cartilage interface crosstalk in osteoarthritis: potential pathways and future therapeutic strategies. Osteoarthr Cartil 22:1077–1089. doi:10.1016/j.joca.2014.05.023 CrossRefPubMed

Bellido M, Lugo L, Roman-Blas JA, Castañeda S, Caeiro JR, Dapia S, Calvo E, Largo R, Herrero-Beaumont G (2010) Subchondral bone microstructural damage by increased remodelling aggravates experimental osteoarthritis preceded by osteoporosis. Arthritis Res Ther 12:R152. doi:10.1186/ar3103 CrossRefPubMedPubMedCentral

10.

Burr DB, Gallant MA (2012) Bone remodeling in osteoarthritis. Nat Rev Rheumatol 8:665–673. doi:10.1038/nrrheum.2012.130 CrossRefPubMed

11.

Siebelt M, Waarsing JH, Groen HC, Müller C, Koelewijn SJ, de Blois E, Verhaar JA, de Jong M, Weinans H (2014) Inhibited osteoclastic bone resorption through alendronate treatment in rats reduces severe osteoarthritis progression. Bone 66:163–170. doi:10.1016/j.bone.2014.06.009 CrossRefPubMed

12.

Mohan G, Perilli E, Parkinson IH, Humphries JM, Fazzalari NL, Kuliwaba JS (2013) Pre-emptive, early, and delayed alendronate treatment in a rat model of knee osteoarthritis: effect on subchondral trabecular bone microarchitecture and cartilage degradation of the tibia, bone/cartilage turnover, and joint discomfort. Osteoarthr Cartil 21:1595–1604. doi:10.1016/j.joca.2013.06.020 CrossRefPubMed

13.

Solomon L (1976) Patterns of osteoarthritis of the hip. J Bone Joint Surg Br 58:176–183PubMed

14.

Conrozier T, Merle-Vincent F, Mathieu P, Richard M, Favret H, Piperno M, Caton J, Vignon E (2004) Epidemiological, clinical, biological and radiological differences between atrophic and hypertrophic patterns of hip osteoarthritis: a case-control study. Clin Exp Rheumatol 22:403–408PubMed

15.

Ledingham J, Dawson S, Preston B, Milligan G, Doherty M (1992) Radiographic patterns and associations of osteoarthritis of the hip. Ann Rheum Dis 51:1111–1116CrossRefPubMedPubMedCentral

16.

Reijman M, Hazes JM, Pols HA, Koes BW, Bierma-Zeinstra SM (2005) Acetabular dysplasia predicts incident osteoarthritis of the hip: the Rotterdam study. Arthritis Rheum 52:787–793CrossRefPubMed

17.

Jacobsen S, Sonne-Holm S, Søballe K, Gebuhr P, Lund B (2005) Hip dysplasia and osteoarthrosis: a survey of 4151 subjects from the Osteoarthrosis Substudy of the Copenhagen City Heart Study. Acta Orthop 76:149–158CrossRefPubMed

18.

Li L, Wang X, Zhao Q, Wang E, Wang L, Cheng J, Zhang L, Wang B (2017) CX3CR1 polymorphisms associated with an increased risk of developmental dysplasia of the hip in human. J Orthop Res 35:377–380. doi:10.1002/jor.23294 CrossRefPubMed

19.

Jingushi S, Ohfuji S, Sofue M, Hirota Y, Itoman M, Matsumoto T, Hamada Y, Shindo H, Takatori Y, Yamada H, Yasunaga Y, Ito H, Mori S, Owan I, Fujii G, Ohashi H, Iwamoto Y, Miyanishi K, Iga T, Takahira N, Sugimori T, Sugiyama H, Okano K, Karita T, Ando K, Hamaki T, Hirayama T, Iwata K, Nakasone S, Matsuura M, Mawatari T (2011) Osteoarthritis hip joints in Japan: involvement of acetabular dysplasia. J Orthop Sci 16:156–164. doi:10.1007/s00776-011-0025-7 CrossRefPubMed

20.

Yoshimura N, Campbell L, Hashimoto T, Kinoshita H, Okayasu T, Wilman C, Coggon D, Croft P, Cooper C (1998) Acetabular dysplasia and hip osteoarthritis in Britain and Japan. Br J Rheumatol 37:1193–1197CrossRefPubMed

21.

Jingushi S, Ohfuji S, Sofue M, Hirota Y, Itoman M, Matsumoto T, Hamada Y, Shindo H, Takatori Y, Yamada H, Yasunaga Y, Ito H, Mori S, Owan I, Fujii G, Ohashi H, Iwamoto Y, Miyanishi K, Iga T, Takahira N, Sugimori T, Sugiyama H, Okano K, Karita T, Ando K, Hamaki T, Hirayama T, Iwata K, Nakasone S, Matsuura M, Mawatari T (2010) Multiinstitutional epidemiological study regarding osteoarthritis of the hip in Japan. J Orthop Sci 15:626–631. doi:10.1007/s00776-010-1507-8 CrossRefPubMed

22.

Richette P, Corvol M, Bardin T (2003) Estrogens, cartilage, and osteoarthritis. Joint Bone Spine 70:257–262CrossRefPubMed

23.

Sharp IK (1961) Acetabular dysplasia. The acetabular angle. J Bone Joint Surg Br 43:268–272

24.

Massie WK, Howorth MB (1950) Congenital dislocation of the hip. Part I. Method of grading results. J Bone Joint Surg Am 32-A:519–531CrossRefPubMed

25.

Heyman CH, Herndon CH (1950) Legg-Perthes disease; a method for the measurement of the roentgenographic result. J Bone Joint Surg Am 32-A:767–778CrossRefPubMed

26.

Takatori Y, Ito K, Sofue M, Hirota Y, Itoman M, Matsumoto T, Hamada Y, Shindo H, Yamada H, Yasunaga Y, Ito H, Mori S, Owan I, Fujii G, Ohashi H, Mawatari T, Iga T, Takahira N, Sugimori T, Sugiyama H, Okano K, Karita T, Ando K, Hamaki T, Hirayama T, Iwata K, Matsuura M, Jingushi S (2010) Analysis of interobserver reliability for radiographic staging of coxarthrosis and indexes of acetabular dysplasia: a preliminary study. J Orthop Sci 15:14–19. doi:10.1007/s00776-009-1412-1 CrossRefPubMed

27.

Bombelli R (1983) Osteoarthritis of the hip: classification and pathogenesis: the role of osteotomy as a consequent therapy, 2nd edn. Springer, Berlin

28.

Saito M, Saito S, Ohzono K, Ono K (1987) The osteoblastic response to osteoarthritis of the hip. Its influence on the long-term results of arthroplasty. J Bone Joint Surg Br 69:746–751

29.

Genant HK, Wu CY, van Kuijk C, Nevitt MC (1993) Vertebral fracture assessment using a semiquantitative technique. J Bone Miner Res 8:1137–1148CrossRefPubMed

30.

Lane NE, Nevitt MC, Cooper C, Pressman A, Gore R, Hochberg M (1997) Acetabular dysplasia and osteoarthritis of the hip in elderly white women. Ann Rheum Dis 56:627–630CrossRefPubMedPubMedCentral

31.

Sandell LJ (2012) Etiology of osteoarthritis: genetics and synovial joint development. Nat Rev Rheumatol 8:77–89. doi:10.1038/nrrheum.2011.199 PubMed

32.

Schnitzler CM, Mesquita JM, Wane L (1992) Bone histomorphometry of the iliac crest, and spinal fracture prevalence in atrophic and hypertrophic osteoarthritis of the hip. Osteoporos Int 2:186–194CrossRefPubMed

33.

Bierma-Zeinstra SM, Koes BW (2007) Risk factors and prognostic factors of hip and knee osteoarthritis. Nat Clin Pract Rheumatol 3:78–85CrossRefPubMed

34.

Castaño-Betancourt MC, Rivadeneira F, Bierma-Zeinstra S, Kerkhof HJ, Hofman A, Uitterlinden AG, van Meurs JB (2013) Bone parameters across different types of hip osteoarthritis and their relationship to osteoporotic fracture risk. Arthritis Rheum 65:693–700. doi:10.1002/art.37792 CrossRefPubMed

35.

Calvo E, Castañeda S, Largo R, Fernández-Valle ME, Rodríguez-Salvanés F, Herrero-Beaumont G (2007) Osteoporosis increases the severity of cartilage damage in an experimental model of osteoarthritis in rabbits. Osteoarthr Cartil 15:69–77CrossRefPubMed

36.

Nishii T, Tamura S, Shiomi T, Yoshikawa H, Sugano N (2013) Alendronate treatment for hip osteoarthritis: prospective randomized 2-year trial. Clin Rheumatol 32:1759–1766. doi:10.1007/s10067013-2338-8

37.

Li G, Yin J, Gao J, Cheng TS, Pavlos NJ, Zhang C, Zheng MH (2013) Subchondral bone in osteoarthritis: insight into risk factors and microstructural changes. Arthritis Res Ther 15:223

38.

Lane NE, Lin P, Christiansen L, Gore LR, Williams EN, Hochberg MC, Nevitt MC (2000) Association of mild acetabular dysplasia with an increased risk of incident hip osteoarthritis in elderly white women: the study of osteoporotic fractures. Arthritis Rheum 43:400–404

39.

Okano K, Aoyagi K, Chiba K, Motokawa S, Matsumoto T (2011) Bone mineral density is not related to osteophyte formation in osteoarthritis of the hip. J Rheumatol 38:358–361. doi:10.3899/jrheum.100533

Title: Osteoarthritis of the hip joint in elderly patients is most commonly atrophic, with low parameters of acetabular dysplasia and possible involvement of osteoporosis
Authors: Yasuhiro Ishidou
Kanehiro Matsuyama
Daisuke Sakuma
Takao Setoguchi
Satoshi Nagano
Ichiro Kawamura
Shingo Maeda
Setsuro Komiya
Publication date: 01-12-2017
Publisher: Springer London
Published in: Archives of Osteoporosis / Issue 1/2017
Print ISSN: 1862-3522
Electronic ISSN: 1862-3514
DOI: https://doi.org/10.1007/s11657-017-0325-4

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Osteoarthritis of the hip joint in elderly patients is most commonly atrophic, with low parameters of acetabular dysplasia and possible involvement of osteoporosis

Abstract

Summary

Introduction

Methods

Results

Conclusion

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Abstract

Summary

Introduction

Methods

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Conclusion

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