Increased Bone Mineral Content but Not Bone Mineral Density in the Hip in Surgically Treated Knee and Hip Osteoarthritis

Objective: The inverse relationship between the occurrence of osteoarthritis (OA) and osteoporosis is controversial. Some investigators have found higher bone mineral density (BMD) in the hips, lumbar spine, and other skeletal sites of patients with OA; others have not. We investigated the relationship between BMD and OA.

Methods: We compared the BMD, bone mineral content (BMC), and projected area of the femoral neck (FN) and trochanter (TR) of 99 women with a validated diagnosis of primary OA from the Kuopio Osteoporosis Risk Factor and Prevention Study (OSTPRE) cohort, with 2012 controls. The measurements were made twice in women aged 47-59 years in 1989-91, and then repeated in 1994-98.

Results: After correction for age, body mass index (BMI), menopausal status, and hormone replacement therapy use before inclusion, we found no significant difference in femoral BMD of the OA patients compared with controls at baseline and at 5-year followup (FN +2.7%, +4.6%, respectively; nonsignificant). However, the BMC was significantly higher in all regions of interest in OA patients at baseline [FN +8.3% (p = 0.004); TR +13.3% (p = 0.017)]. The projected area of FN was also significantly higher at baseline and followup in OA patients (FN +3.7%, +3.9%, respectively; p < 0.001). The projected area of the bones increased in all subjects over the followup period. The BMD decrease rate was higher in OA patients for all regions of interest during followup.

Conclusion: Hip BMD of women treated surgically for hip or knee OA was not different from that of healthy controls when measured twice with a 5-year interval. However, at 5-year followup, OA can be accompanied by an increase in bone size or changes in shape, and faster loss of BMD.