title: Osteoarthritis and bone mineral density: are strong bones bad for joints?
abstract: Osteoarthritis (OA) is a common and disabling joint disorder affecting millions of people worldwide. In OA, pathological changes are seen in all of the joint tissues including bone. Although both cross-sectional and longitudinal epidemiological studies have consistently demonstrated an association between higher bone mineral density (BMD) and OA, suggesting that increased BMD is a risk factor for OA, the mechanisms underlying this observation remain unclear. Recently, novel approaches to examining the BMD-OA relationship have included studying the disease in individuals with extreme high bone mass, and analyses searching for genetic variants associated with both BMD variation and OA, suggesting possible pleiotropic effects on bone mass and OA risk. These studies have yielded valuable insights into potentially relevant pathways that might one day be exploited therapeutically. Although animal models have suggested that drugs reducing bone turnover (antiresorptives) may retard OA progression, it remains to be seen whether this approach will prove to be useful in human OA. Identifying individuals with a phenotype of OA predominantly driven by increased bone formation could help improve the overall response to these treatments. This review aims to summarise current knowledge regarding the complex relationship between BMD and OA.
authors: Musculoskeletal Research Unit, School of Clinical Sciences, University of Bristol , Bristol, UK ; MRC Integrative Epidemiology Unit (IEU), School of Social and Community Medicine, University of Bristol , Bristol, UK.
authors: Sarah A
authors: SA
authors: Hardcastle
authors: Musculoskeletal Research Unit, School of Clinical Sciences, University of Bristol , Bristol, UK ; University of Exeter Medical School , Exeter, UK.
authors: Paul
authors: P
authors: Dieppe
authors: Musculoskeletal Research Unit, School of Clinical Sciences, University of Bristol , Bristol, UK.
authors: Celia L
authors: CL
authors: Gregson
authors: MRC Integrative Epidemiology Unit (IEU), School of Social and Community Medicine, University of Bristol , Bristol, UK.
authors: George
authors: G
authors: Davey Smith
authors: Musculoskeletal Research Unit, School of Clinical Sciences, University of Bristol , Bristol, UK.
authors: Jon H
authors: JH
authors: Tobias
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