High Bone Mineral Density Predicts Progression of Knee, Hip Osteoarthritis

Bone density scan
Bone density scan
Researchers examined the longitudinal relationship between bone mineral density and the incidence and progression of knee, hip, and hand osteoarthritis.

Femoral neck bone mineral density (BMD) is a strong prognostic indicator of the development of radiographic knee and hip osteoarthritis (OA), according to study data published in Arthritis & Rheumatology.

Investigators abstracted patient radiographic data from the Rotterdam Study I (n=3005; 55.8% women) and Rotterdam Study II (n=1149; 54.4% women). Patients were selected for the current study based on availability of knee, hip, and hand radiographs at baseline and follow-up examinations. In addition, data on BMD and prevalent fractures at baseline were collected. Mean follow-up time was 8.4 and 4.1 years for participants in Rotterdam Study I and II, respectively. Radiographs were scored for incidence and progression of knee and hip OA and incidence of hand OA. Prevalent vertebral fractures were scored at baseline according to the McCloskey/Kanis method, and non-vertebral fractures were reported at an interview at baseline.

Age- and sex-specific quartiles for femoral neck BMD suggested a strong correlation between high femoral neck BMD and the risk for incident knee ROA (odds ratio [OR], 1.58; 95% CI, 1.14-2.18). The highest femoral neck BMD quartile was also associated with increased risk for incident radiographic hip OA (OR, 1.57; 95% CI, 1.06-2.32) compared with the lowest quartile. However, no significant association was found between high femoral neck BMD and the progression of radiographic knee or hip OA or the incidence of radiographic hand OA. Prevalent vertebral fractures at baseline were associated with incident radiographic hand OA (OR, 1.74; 95% CI, 1.02-2.98), although not with radiographic knee or hip OA. Non-vertebral fractures at baseline were not associated with any radiographic OA outcomes.

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These data confirm existing scientific evidence that high FN-BMD is a strong risk factor for subsequent radiographic knee OA. Given that little association was found between BMD and incident hand ROA, researchers suggested that the effect of BMD on radiographic OA risk is strongest in “weight-bearing joints.” These data provide useful prognostic information for clinicians working with knee and hip OA.  

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Bergink AP, Rivadeneira F, Bierma-Zeinstra SM. Are bone mineral density and fractures related to the incidence and progression of radiographic osteoarthritis of the knee, hip and hand in elderly men and women? The Rotterdam study [published online September 28, 2018]. Arthritis Rheumatol. doi:10.1002/art.40735