Li Li, Huang Rui, Gao Xiang, Li Zhenxing, Lin Yuanyuan, Zhang Hanle, Jiang Yilun, Fan Pei
Key Laboratory of Pediatric Anesthesiology, Ministry of Education, Precision Anesthesiology Key Laboratory of Zhejiang Province, The Second Affiliated Hospital of Wenzhou Medical University, Yuying Children'S Hospital, Wenzhou, Zhejiang Province, China.
Department of Orthopedics, The Second Affiliated Hospital of Wenzhou Medical University, Yuying Children'S Hospital, No. 109, Xueyuan West Road, Wenzhou, Zhejiang Province, China.
BMC Musculoskelet Disord. 2025 Mar 3;26(1):217. doi: 10.1186/s12891-025-08389-2.
Osteoporosis is common in patients with knee osteoarthritis (KOA) awaiting total knee arthroplasty (TKA) and varies in different regional and ethnic. However, it is unclear whether the prevalence of osteoporosis and osteopenia in these patients is different from that in the general population. This study aims to investigate the prevalence of osteoporosis and osteopenia in both populations to help exploring the relationship between the osteoporosis and osteoarthritis, and to explore whether knee function and radiological assessments of KOA are associated with osteoporosis.
In total, 249 patients diagnosed with KOA awaiting TKA were investigated in this cross-sectional study. The mean age was 70.9 ± 6.4 years. Bone mineral density (BMD) and T scores at the hip and lumbar spine were used to assess bone status using dual X-ray absorptiometry. A matched cohort from 2448 individuals in the Health Examination Center of our hospital was set as controls by matching sex, age (± 3.0 years) and BMI (± 1.0). The Kellgren-Lawrence grades (K-L grades), mechanical femorotibial angle (mFTA), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score and range of motion (ROM) of the knee were measured to evaluate radiological assessments and knee function in patients awaiting TKA and used to explore the association between KOA and BMD or T score. Prevalence of osteoporosis and osteopenia were investigated in the two cohorts, and inferential statistical analyses were undertaken. The chi-squared test or Fisher's exact test was used for categorical variables while comparisons of scores were examined by ANOVA with/without Bonferroni correction or the Kruskal‒Wallis test.
The prevalence of osteoporosis and osteopenia in patients awaiting TKA was 30.5% (76/249) and 44.2% (110/249), respectively. In the matched cohort, 72/249 (28.9%) had osteoporosis, while 98/249 (39.4%) had osteopenia. There was no significant difference in the prevalence of osteoporosis or osteopenia between the two groups (χ2 = 2.603, P = 0.272). mFTA was significantly correlated with BMD and T score (P < 0.05), while no correlation was found between K-L grade, ROM or WOMAC and BMD or T score (P > 0.05).
The prevalence of osteoporosis in patients awaiting TKA was similar to that in the general population. BMD and T score were not correlated with WOMAC score or K-L grade but were correlated with mFTA.
骨质疏松症在等待全膝关节置换术（TKA）的膝关节骨关节炎（KOA）患者中很常见，并且在不同地区和种族中存在差异。然而，目前尚不清楚这些患者中骨质疏松症和骨质减少症的患病率是否与普通人群不同。本研究旨在调查这两个人群中骨质疏松症和骨质减少症的患病率，以帮助探索骨质疏松症与骨关节炎之间的关系，并探讨KOA的膝关节功能和影像学评估是否与骨质疏松症相关。
在这项横断面研究中，共调查了249例诊断为KOA并等待TKA的患者。平均年龄为70.9±6.4岁。使用双能X线吸收法测量髋部和腰椎的骨密度（BMD）和T值，以评估骨状态。将我院健康体检中心2448名个体组成的匹配队列作为对照，按照性别、年龄（±3.0岁）和体重指数（±1.0）进行匹配。测量等待TKA患者的Kellgren-Lawrence分级（K-L分级）、机械性股胫角（mFTA）、西安大略和麦克马斯特大学骨关节炎指数（WOMAC）评分以及膝关节活动范围（ROM），以评估影像学评估和膝关节功能，并用于探索KOA与BMD或T值之间的关联。调查两个人群中骨质疏松症和骨质减少症的患病率，并进行推断性统计分析。分类变量采用卡方检验或Fisher精确检验，而分数比较则通过有无Bonferroni校正的方差分析或Kruskal-Wallis检验进行。
等待TKA患者中骨质疏松症和骨质减少症的患病率分别为30.5%（76/249）和44.2%（110/249）。在匹配队列中，72/249（28.9%）患有骨质疏松症，而98/249（39.4%）患有骨质减少症。两组之间骨质疏松症或骨质减少症的患病率无显著差异（χ2=2.603，P=0.272）。mFTA与BMD和T值显著相关（P<0.05），而K-L分级、ROM或WOMAC与BMD或T值之间未发现相关性（P>0.05）。
等待TKA患者中骨质疏松症的患病率与普通人群相似。BMD和T值与WOMAC评分或K-L分级无关，但与mFTA相关。
