Anand Vijender, Gupta Ajay, Sethi Satyaranjan, Kumar Sushil
Department of Physical Medicine and Rehabilitation, VMMC & Safdarjung Hospital, New Delhi, India.
Department of Physical Medicine and Rehabilitation, AIIMS Raebareli, Uttar Pradesh, India.
J Family Med Prim Care. 2022 Feb;11(2):599-602. doi: 10.4103/jfmpc.jfmpc_1006_21. Epub 2022 Feb 16.
Osteoarthritis (OA) of the knee is the most common rheumatic disease that is characterized by degradation of articular cartilage, subchondral bone alteration, meniscal degeneration, synovial inflammatory response, and overgrowth of bone and cartilage. In severe OA, the reduced mobility caused by pain can increase bone loss and reduction of bone mineral density leading to osteoporosis.
To examine the possible relationship between severity of osteoarthritis (OA) and bone mineral density (BMD) by evaluating the bone mineral density in ipsilateral proximal femur and radiographic grading of knee OA in the Indian population.
In this cross-sectional observational study, 100 subjects diagnosed with OA knee using ACR criteria were enrolled. Severity of OA knee was assessed using Kellgren-Lawrence scale (1 to 4) on weight-bearing radiographs. The BMD, T-score, and Z-score of the ipsilateral proximal femur was measured by dual-energy X-ray absorptiometry. Pearson's correlation coefficient was used to test the association of severity of OA knee with BMD.
Among 100 subjects, there were 51 females and 49 males with mean age 59.94 ± 6.67. Maximum patients were with K-L grade 2 (42%) followed by grade 3 (30%) and grade 4 (22%). There was statistically significant (p < 0.0001) association between BMD and severity of OA knee. BMD decreased as the K-L grade of OA knee increased from 1 to 4. Similar statistically significant association was observed in T-score and Z-score.
The study concluded that BMD of ipsilateral proximal femur decreases with severity of OA knee. These data support the fact that the two conditions may be related to each other and primary care physicians must look for these two conditions in coexistence. Primary prevention of either of the two conditions should be advised, if the other condition coexists in the same patient.
膝关节骨关节炎（OA）是最常见的风湿性疾病，其特征为关节软骨退变、软骨下骨改变、半月板退变、滑膜炎症反应以及骨与软骨过度生长。在重度OA中，疼痛导致的活动能力下降会增加骨质流失并降低骨密度，进而引发骨质疏松。
通过评估印度人群同侧股骨近端的骨密度以及膝关节OA的影像学分级，研究骨关节炎（OA）严重程度与骨密度（BMD）之间的可能关系。
在这项横断面观察性研究中，纳入了100名根据美国风湿病学会（ACR）标准诊断为膝关节OA的受试者。在负重X线片上使用凯尔格伦-劳伦斯量表（1至4级）评估膝关节OA的严重程度。通过双能X线吸收法测量同侧股骨近端的骨密度、T值和Z值。采用Pearson相关系数检验膝关节OA严重程度与骨密度之间的关联。
100名受试者中，有51名女性和49名男性，平均年龄为59.94±6.67岁。最多患者为K-L 2级（42%），其次是3级（30%）和4级（22%）。骨密度与膝关节OA严重程度之间存在统计学显著关联（p<0.0001）。随着膝关节OA的K-L分级从1级增加到4级，骨密度降低。在T值和Z值中也观察到类似的统计学显著关联。
该研究得出结论，同侧股骨近端的骨密度随膝关节OA严重程度降低。这些数据支持了这两种情况可能相互关联的事实，初级保健医生必须留意这两种情况同时存在的情况。如果同一患者同时存在这两种情况中的任何一种，建议对其中任何一种情况进行一级预防。
