Distribution of bone mineral density at the proximal tibia in knee osteoarthritis
Distribution of bone mineral density at the proximal tibia in knee osteoarthritis
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DOI：
10.1007/s00223-001-2112-9
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发表时间：
2002-10-01
影响因子：
4.2
通讯作者：
Vielpeau, C
中科院分区：
文献类型：
--
作者：
Hulet, C;Sabatier, JP;Vielpeau, C
对113例骨关节炎（OA）患者的胫骨近端骨密度（BMD）分布进行了研究，并探讨了骨关节炎与骨质疏松症在评估髋部BMD中的潜在关系。所有患者都有严重的膝关节疼痛，并被诊断为Kellgren和Lawrence IV级骨关节炎。根据轴向畸形程度分为4类：内翻> 10 °（28.3%）、内翻4- 10 °（38.9%）、对线180 ± 3 °（13.3%）和外翻> 4 °（19.5%）。对于每个类别，评估内侧和外侧胫骨近端密度。采用双能X线骨密度仪测量股骨颈和胫骨近端14个感兴趣区域（ROI）的BMD。根据股骨颈BMD，根据世界卫生组织（WHO）对骨质疏松症的定义对患者进行分类。膝关节骨密度与髋关节骨密度呈正相关（膝关节骨密度m = 0.38 + 0.73 ×髋关节骨密度，r = 0.60，P < 0.001）。113例患者膝关节骨密度分布与轴性畸形呈负相关（BMDMT-LT = 5.15- 0.027xHKA，r = 0.77，P < 0.0001）。在内翻畸形中，内侧的BMD高于外侧，且具有重要的不对称性（0.587 g/cm（2））。这种不对称性也见于外侧外翻畸形，但不太重要（-0.112 g/cm）。在畸形相同的情况下，内翻畸形的骨密度不对称性（0.587g/cm 2）高于外翻畸形（-0.112g/cm2）。膝关节BMD分布的不对称性表明，畸形（内翻或外翻）的进展与关节间隙狭窄导致胫骨近端密度的内外侧差异增加。Kellgren和Lawrence分级的较低严重程度可能揭示不同的结果。20例骨质疏松症患者发生膝骨关节炎（OA），骨质疏松症与膝骨关节炎之间的关系尚不清楚。
One hundred and thirteen knees with osteoarthritis (OA) were studied to assess the distribution of bone mineral density (BMD) in the proximal tibia and the potential relation between osteoarthritis and osteoporosis in evaluating hip BMD. All patients had severe knee pain and were diagnosed with Kellgren and Lawrence grade IV osteoarthritis. According to the magnitude of the axial deformity, four categories were created: varus> 10degrees (28.3%), varus 4-10degrees (38.9%), aligned 180 +/- 3degrees (13.3%), and valgus> 4degrees (19.5%). For each category, the medial and lateral proximal tibial density were assessed. BMD was measured at the femoral neck and at 14 regions of interest (ROI) in the proximal part of the tibia using dual X-ray absorptiometry. Based on the femoral neck BMD, patients were classified according to the World Health Organization (WHO) definition of osteoporosis. The mean knee BMD was positively correlated with the hip BMD value (knee BMDm = 0.38 + 0.73 x hip BMD, r = 0.60, P < 0.001). The knee BMD distribution of the 113 patients was negatively correlated with the axial deformity (BMDMT-LT = 5.15-0.027 x HKA, r = 0.77, P < 0.0001). In the varus deformity, BMD of the medial side was higher than that of the lateral side with an important asymmetry (0.587 g/cm(2)). This asymmetry was also found in the vaLgus deformity for the lateral side but was less important (-0.112 g/cm). With equal deformity, the asymmetry of BMD was higher in varus deformity (0.587 g/cm(2)) than in valgus deformity (-0.112 g/cm(2)). Asymmetry of the knee BMD distribution revealed that progression of the deformity (either varus or valgus) with joint space narrowing led to an increase in the mediolateral difference of the proximal tibia density. Lesser severity of Kellgren and Lawrence grades may reveal different results. Twenty patients with osteoporosis developed knee osteoarthritis (OA) and the relation between osteoporosis and knee OA remains unclear.