Bone parameters across different types of hip osteoarthritis and its relation to osteoporotic fracture risk.

Department of Epidemiology, Erasmus Medical Center Rotterdam, Rotterdam, the Netherlands.
Arthritis & Rheumatology (Impact Factor: 7.87). 03/2013; 65(3). DOI: 10.1002/art.37792
Source: PubMed

ABSTRACT OBJECTIVES.: Atrophic type of hip osteoarthritis (OA) is characterised by cartilage degradation without formation of osteophytes. Individuals with atrophic OA have been less studied and it is unknown whether they differ from osteophytic types regarding bone tissue. We here examined BMD, hip structural properties and fracture risk in individuals with atrophic OA type compared to individuals with osteophytic types (normotrophic/hypertrophic) and to individuals without OA. METHODS.: This study is part of the Rotterdam Study, a large prospective population based cohort study. We examined 5006 participants who were assessed for osteoarthritis, BMD, and geometry measures at baseline and incident non-vertebral osteoporotic (OP) fractures (mean follow-up time of 9.6 years). We estimated differences in bone characteristics between the OA-groups and controls. Cox's proportional hazards regression was used to calculate OP fracture risk. RESULTS.: Participants with atrophic OA had systemically lower BMD compared to normotrophic type and controls respectively (6.5 and 9% in total body and 4 and 5% in skull-BMD respectively). Participants with osteophytic OA had approximately 4 and 5% higher total body- and skull-BMD, wider femoral neck and greater bone strength (12 and 5% higher section modulus) compared to controls or atrophic OA . However, the risk of OP fractures was almost 50% higher in the atrophic group compared to controls (HR: 1.48, p: 0.008). It was not explained by differences in BMD, falling, disability or corticosteroid use. CONCLUSIONS: Individuals with atrophic hip OA have an increased risk for OP fractures not fully explained by systemically lower BMD compared to controls. © 2012 American College of Rheumatology.

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