Relationship Between Low Bone Mineral Density and Varus Deformity in Postmenopausal Women with Knee Osteoarthritis
Relationship Between Low Bone Mineral Density and Varus Deformity in Postmenopausal Women with Knee Osteoarthritis
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DOI：
10.3899/jrheum.080699
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发表时间：
2009-03-01
影响因子：
3.9
通讯作者：
Saito, Tomoyuki
中科院分区：
文献类型：
--
作者：
Akamatsu, Yasushi;Mitsugi, Naoto;Saito, Tomoyuki
objective.目的探讨绝经后妇女膝关节骨关节炎（OA）引起的骨结构改变所引起的内翻畸形与骨密度（BMD）的关系。这项横断面研究纳入了135名患有膝内翻OA且Kelling-Lawrence分级≥ 2的连续绝经后女性患者。在患者单莱亚站立的情况下拍摄膝关节X线片，根据股胫角将受试者分为3个三分位组，股胫角作为膝内翻OA严重程度的指标。我们还测量了构成股胫角的3个亚角，并重点关注胫骨平台的内翻倾斜度。采用双能X线骨密度仪测量腰椎、股骨颈、胫骨内外侧髁骨密度。评估股胫角三分位组之间的差异。并分析股胫各亚角与各点骨密度值的关系。校正年龄和体重指数后，胫骨平台内翻倾斜度与腰椎BMD无显著相关性。胫骨平台内翻倾斜度与同侧股骨近端和胫骨外侧髁骨密度呈弱的负相关，但有统计学意义。股胫前3分位组和同侧下肢BMD较低的患者胫骨平台内翻倾斜明显更严重。膝关节内翻OA不仅可能由软骨损失引起，也可能由骨结构变化引起。（2009年2月1日首次发布; J Rheumol 2009; 36：592 - 7：doi：10.3899/jrheum.080699）
Objective. To assess the relationship between bone mineral density (BMD) and varus deformity arising from bone structural changes caused by knee osteoarthritis (OA) in postmenopausal women.Methods. This cross-sectional study involved 135 consecutive postmenopausal female patients who had varus knee OA and a Kellgren-Lawrence grade >= 2. Knee radiographs were obtained with the patient standing on one lea, and subjects were classified into 3 tertile groups according to femorotibial angle, which was taken as a measure of varus knee OA severity. We also measured the 3 subangles that make up the femorotibial angle, and focused on the varus inclination of the tibial plateau. BMD was measured in the lumbar spine, femoral neck, and medial and lateral tibial condyles using dual-energy X-ray absorptiometry. Differences between femorotibial angle tertile groups were assessed. and associations between femorotibial sub-angles and BMD values at various points were evaluated.Results. After adjustment for age and body mass index, there was no significant association between the varus inclination of the tibial plateau and lumbar spine BMD. A weak but statistically significant negative correlation existed between varus inclination of the tibial plateau and BMD at the ipsilateral proximal femur and lateral tibial condyle.Conclusion. Varus inclination of the tibial plateau was significantly more severe in the femorotibial an-le tertile 3 group, and in patients with lower BMD in the ipsilateral lower limb. Varus knee OA may result not only from cartilage loss but also from structural changes of the bone. (First Release Feb 1 2009; J Rheumatol 2009;36:592-7: doi: 10.3899/jrheum.080699)