Differences in hip bone mineral density may explain the hip fracture pattern in osteoarthritic hips.
BACKGROUND
In patients with osteoarthritis of the hip (OAH), trochanteric fractures are much more common than femoral neck fractures. One reason may be altered bone composition in the proximal femurs. OAH often leads to a fixed external rotation of the hip, leading to difficulties in positioning during DXA measurements. We compared BMD in OAH-affected legs and healthy legs.


METHODS
40 patients with strictly unilateral OAH were cross-sectionally investigated with DXA at the hips and heels bilaterally as well as body composition of the legs. 3 regions of interest in the proximal femur were measured: femoral neck (FN), trochanter (TR), and total hip (TH). The design of the study allowed us to perform paired t-test between the OAH side and the healthy side.


RESULTS
BMD was increased by 4.1% in FN, and reduced by 8.3% in TR and 4.1% in TH (p < 0.001 for all comparisons).


CONCLUSIONS
The differences in BMD, with decrease in the trochanter and increase in the femoral neck, may offer an explanation for the pattern of hip fractures seen in osteoarthritis. External rotation of the hip cannot explain the differences in BMD.
Wolf
Olof
O
Department of Orthopedics, Uppsala University Hospital, Sweden. olof.wolf@akademiska.se
Ström
Håkan
H
Milbrink
Jan
J
Larsson
Sune
S
Mallmin
Hans
H
D015502:Absorptiometry, Photon; D000368:Aged; D015519:Bone Density; D003430:Cross-Sectional Studies; D005260:Female; D005265:Femoral Neck Fractures / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology*; D005272:Femur Neck / Q000378:metabolism / Q000503:physiopathology*; D006620:Hip Fractures / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology*; D006621:Hip Joint / Q000378:metabolism / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000150:complications / Q000378:metabolism / Q000503:physiopathology*; D012399:Rotation; D016474:Weight-Bearing