Relationship between low bone mineral density and varus deformity in postmenopausal women with knee osteoarthritis.
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 > or = 2. Knee radiographs were obtained with the patient standing on one leg, 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.


CONCLUSIONS
Varus inclination of the tibial plateau was significantly more severe in the femorotibial angle 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.
Akamatsu
Yasushi
Y
Department of Orthopaedic Surgery, Yokohama City University Medical Center, Yokohama City 232-0024, Japan. akamatsu@yokohama-cu.ac.jp
Mitsugi
Naoto
N
Taki
Naoya
N
Takeuchi
Ryohei
R
Saito
Tomoyuki
T
D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000473:pathology*; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000150:complications / Q000473:pathology* / Q000503:physiopathology; D015663:Osteoporosis, Postmenopausal / Q000150:complications / Q000503:physiopathology*