Abstract
We aimed to compare proximal femur geometry and biomechanics in postmenopausal women with osteoarthritis (OA) and/or osteoporosis (OP), using quantitative computed tomography (QCT). A retrospective analysis of QCT scans of the proximal femur of 175 postmenopausal women was performed. Morphometric and densitometric data of the proximal femur were used to evaluate its biomechanics. We found, 21 had a normal bone mineral density (BMD), 72 had osteopenia, and 81 were diagnosed with OP. Radiographic findings of hip OA were seen in 43.8%, 52.8%, and 39.5% of the normal BMD, osteopenic, and OP groups, respectively (p < 0.05). OA was significantly correlated with total hip volume (r = 0.21), intertrochanteric cortical volume (r = 0.25), and trochanteric trabecular volume (r = 0.20). In each densitometric group, significant differences in hip geometry and BMD were found between the OA and non-OA subgroups. Hip OA and OP often coexist. In postmenopausal women, these diseases coexist in 40% of cases. Both OA and OP affect hip geometry and biomechanics. OA does so regardless of densitometric status. Changes are mostly reflected in the cortical bone. OA leads to significant changes in buckling ratio (BR) in both OP and non-OP women.
Highlights
The prevalence of osteoarthritis (OA) increases with age [1,2,3,4], as does osteoporosis (OP) [5,6,7]
12% had a normal bone mineral density (BMD), 41.1% met the densitometric criteria of osteopenia, and 46.9% were diagnosed with OP
Radiographic signs of hip OA were seen in 43.8%, 52.8%, and 39.5% in the normal BMD, osteopenic, and OP groups (p < 0.05)
Summary
The prevalence of osteoarthritis (OA) increases with age [1,2,3,4], as does osteoporosis (OP) [5,6,7]. Bone shape continues to be affected by periosteal apposition (modeling) and endosteal resorption and formation (remodeling), resulting in substantial alteration of bone shape and size. Pathological changes, i.e., OA and OP might add to the dynamics of these [12]. Bone morphology and geometry considerably add to the strength model. Separate assessment of the cortical and trabecular bones is necessary to distinguish the differences in their age-related changes, biomechanics, and response to pharmacological and non-pharmacological treatments. The trabecular bone is about eight times more metabolically active than the cortical bone and is subjected to early and rapid changes with advancing age [13,14]
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