Bone turnover markers (BTMs) in the synovial fluid in the patients with osteoarthritis correlates with the serum level of BTMs though some patients with osteoporosis exhibit mismatched increase in bone resorption activity in synovial fluid

Abstract

s / Osteoarthritis and Cartilage 22 (2014) S57–S489 S375 663 BONE TURNOVER MARKERS (BTMS) IN THE SYNOVIAL FLUID IN THE PATIENTS WITH OSTEOARTHRITIS CORRELATES WITH THE SERUM LEVEL OF BTMS THOUGH SOME PATIENTS WITH OSTEOPOROSIS EXHIBIT MISMATCHED INCREASE IN BONE RESORPTION ACTIVITY IN SYNOVIAL FLUID Y. Saita yz, K. Kurata z, T. Sato z, S. Fukasaku z, K. Kaneko y, M. Nemoto z. yDept. of Orthopaedics, Juntendo Univ., Tokyo, Japan; zDept. of Orthopedic Surgery, Kitanarashino Hanawa Hosp., Chiba, Japan Purpose: Little is known regarding the relationships between the osteoarthritis (OA) and osteoporosis especially for the link between the subchondral bone remodeling and pathology of OA. In the patients with severe OA, articular cartilages wear down and subchondral bones become exposed. We hypothesized that BTMs in the synovial fluid would be related to the pathology of OA, and evaluated them in the patients with knee OA. Methods: Twenty seven knees in twenty one postmenopausal women with advanced-stage knee osteoarthritis (Kellgren-Lawrence >2) were analyzed in this study. The average age of patients was 73.4 (range, 52– 83 years). Knee pain was evaluated using visual analogue scales (VAS) and outcome measure for Japanese patients with knee osteoarthritis (JKOM). Tartrate-resistant acidic phosphatase 5b (TRAcP5b) activity and procollagen 1 N-terminal peptide (P1NP) concentrationwere measured both in the serum and synovial fluid. Bone mineral density (BMD) was measured in digital image processing method at second metacarpal bone. In statistics, Spearman’s rank correlation coefficient (r) and statistical significance (p) were calculated using GraphPad Prismversion 6.0 (GraphPad Software). The Mann-Whitney U test was used to compare differences between two independent groups. The values of p 0.5 mm in the index knee) at 3 years was obtained using a Poisson regression model with robust error estimates to obtain relative risk (RR), with adjustment for baseline index JSW, gender, glucosamine use, age, BMI and centre. Each knee was graded according to the Kellgren and Lawrence (KL placebo 0.08 mm/year; 95% CI 0.15–0.30, p 1⁄4 0.51). In the lateral compartment, the equivalent difference between the two groups was 0.07 mm/year (vitamin D 0.11mm/year, placebo 0.18mm/year; 95% CI 0.15–0.30). 39% of patients in the treatment group and 37% of patients in the placebo group showed a clinically significant progression of JSN (>0.5 mm) at 3 years compared to baseline. The unadjusted relative risk of clinically significant progression of JSN for the vitamin D group relative to the placebo group was 1.05 (95% CI 0.77–1.44, p 1⁄4 0.76). The adjusted relative risk was 1.03 (95% CI 0.76–1.40, p 1⁄4 0.83). The odds ratio of a higher KL OVX with alendronate (ALN,