Bone parameters across different types of hip osteoarthritis and its relation to osteoporotic fracture risk.
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.
SourceAvailable from: Jorge A Roman-Blas[Show abstract] [Hide abstract]
ABSTRACT: The identification of well-defined phenotypes along the course of the disease may open new avenues for personalized management in osteoarthritis (OA). In vivo research carried out in various animal models as well as epidemiological and clinical data support the existence of a particular phenotype - osteoporotic OA. In fact, subchondral bone has become a potential therapeutic target in OA. Depending on the ratio between formation and resorption, subchondral bone remodeling can culminate in either a sclerotic or an osteoporotic phenotype. Patients with osteoporotic OA may thus achieve clinical and structural benefit from treatment with bone-targeted interventions.Arthritis Research & Therapy 11/2014; 16(6):494. DOI:10.1186/s13075-014-0494-0 · 4.12 Impact Factor
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ABSTRACT: Osteoporosis, a musculoskeletal disease characterized by decreased bone mineral density (BMD) and an increased risk of fragility fractures, is now recognized as an important public health problem in men. Osteoporotic fractures, particularly of the hip, result in significant morbidity and mortality in men and lead to considerable societal costs. Many national and international organizations now address screening and treatment for men in their osteoporosis clinical guidelines. However, male osteoporosis remains largely underdiagnosed and undertreated. The objective of this paper is to provide an overview of recent findings in male osteoporosis, including pathophysiology, epidemiology, and incidence and burden of fracture, and discuss current knowledge about the evaluation and treatment of osteoporosis in males. In particular, clinical practice guidelines, fracture risk assessment, and evidence of treatment effectiveness in men are addressed.Clinical Epidemiology 01/2015; 7:65. DOI:10.2147/CLEP.S40966
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ABSTRACT: Background Degeneration of cartilage will change load distribution, affecting bone remodeling progress and trabecular structure and strength. However, in human primary osteoporosis, whether cartilage lesions would also affect properties beneath trabecular bone remains unknown. In this study, we explored the differences in local trabecular properties between osteoporosis patients with and without cartilage lesions. Methods Eighteen pairs of femoral heads with and without cartilage lesions in a weight-bearing area were collected from senile femoral neck fracture patients. The Mankin score and glycosaminoglycan (GAG) content were used to evaluate the severity of the cartilage lesions. Micro-CT and compression tests were used to obtain structural and mechanical characteristics of each trabecular column. Multivariate linear regression was performed to evaluate the association between mechanical parameters and the degree of cartilage lesion. Results In osteoporosis patients with cartilage lesions, the bone volume fraction (BV/TV) and trabecular thickness (Tb.Th) of the trabecular column were significantly higher than that of osteoporotic control patients (all P < 0.05), while the Young’s modulus was lower (P = 0.024). Multivariable linear regression indicated that in both groups, bone mineral density (BMD) significantly correlated with Young’s modulus (all P < 0.05). While in patients with cartilage lesion, GAG content was also correlated with Young’s modulus (standardized coefficient 0.443, P < 0.01). Conclusions Osteoporosis patients with cartilage lesions exhibited a weaker mechanical property of trabeculae. The intimate association of cartilage lesions and impairment of trabecular mechanical properties indicate that cartilage and trabeculae belong to an interdependent functional unit. Previously proposed adaptive mechanisms in osteoarthritis might also be applicable to the progression of osteoporosis.BMC Musculoskeletal Disorders 03/2015; 16. DOI:10.1186/s12891-015-0530-5 · 1.90 Impact Factor