Clinical Impact of the Fracture Risk Assessment Tool on the Treatment Decision for Osteoporosis in Patients with Knee Osteoarthritis: A Multicenter Comparative Study of the Fracture Risk Assessment Tool and World Health Organization Criteria

Overview

Journal J Clin Med

Specialty General Medicine

Date 2019 Jun 29

PMID 31248035

Citations 3

Authors

Bo Young Kim

Hyoun-Ah Kim

Ju-Yang Jung

Sang Tae Choi

Ji-Min Kim

Sang Hyon Kim

Seong-Ryul Kwon

Chang-Hee Suh

Sung-Soo Kim

Affiliations

Soon will be listed here.

Abstract

Background: To compare the frequency of high-risk osteoporotic fracture in patients with knee OA (OA) using the fracture risk assessment tool (FRAX) and the bone mineral density (BMD).

Methods: We retrospectively assessed 282 Korean patients with knee OA who visited five medical centers and 1165 healthy controls (HCs) aged ≥50 years without knee OA. After matching for age, sex, and body mass index, 478 subjects (239 patients with knee OA and 239 HCs) were included.

Results: Based on the BMD, the frequency of osteoporosis was 40.2% in patients with knee OA and 36.4% in HCs. The predicted mean FRAX major osteoporotic fracture probabilities calculated with or without femur neck BMD differed significantly between the knee OA and HCs (6.9 ± 3.8% versus 6.1 ± 2.8%, = 0.000 and 8 ± 3.6% versus 6.8 ± 2.3%, < 0.001, respectively). The mean FRAX hip fracture probabilities calculated with or without femur neck BMD differed significantly in the knee OA and HCs (2.1 ± 2.4% versus 1.7 ± 1.8%, = 0.006 and 3 ± 2.3% versus 2.4 ± 1.6%, < 0.001, respectively).

Conclusion: Our study suggests that FRAX may have a clinical impact on treatment decisions to reduce osteoporotic facture in patients with knee OA.

Citing Articles

Improved Prediction of Knee Osteoarthritis by the Machine Learning Model XGBoost.

Su K, Yuan X, Huang Y, Yuan Q, Yang M, Sun J Indian J Orthop. 2023; 57(10):1667-1677.

PMID: 37766962 PMC: 10519887. DOI: 10.1007/s43465-023-00936-0.

Prevalence and Factors of Osteoporosis and High Risk of Osteoporotic Fracture in Patients with Ankylosing Spondylitis: A Multicenter Comparative Study of Bone Mineral Density and the Fracture Risk Assessment Tool.

Kim J, Park S, Jung J, Kim H, Kwon S, Choi S J Clin Med. 2022; 11(10).

PMID: 35628957 PMC: 9146147. DOI: 10.3390/jcm11102830.

Analysis of muscle, hip, and subcutaneous fat in osteoporosis patients with varying degrees of fracture risk using 3T Chemical Shift Encoded MRI.

Martel D, Honig S, Monga A, Chang G Bone Rep. 2020; 12:100259.

PMID: 32322608 PMC: 7163287. DOI: 10.1016/j.bonr.2020.100259.

References

Arden N, Nevitt M, Lane N, Gore L, Hochberg M, Scott J . Osteoarthritis and risk of falls, rates of bone loss, and osteoporotic fractures. Study of Osteoporotic Fractures Research Group. Arthritis Rheum. 1999; 42(7):1378-85. DOI: 10.1002/1529-0131(199907)42:7<1378::AID-ANR11>3.0.CO;2-I. View

Stewart A, Black A . Bone mineral density in osteoarthritis. Curr Opin Rheumatol. 2000; 12(5):464-7. DOI: 10.1097/00002281-200009000-00021. View

Zhang Y, Xu L, Nevitt M, Aliabadi P, Yu W, Qin M . Comparison of the prevalence of knee osteoarthritis between the elderly Chinese population in Beijing and whites in the United States: The Beijing Osteoarthritis Study. Arthritis Rheum. 2001; 44(9):2065-71. DOI: 10.1002/1529-0131(200109)44:9<2065::AID-ART356>3.0.CO;2-Z. View

Kellgren J, Lawrence J . Radiological assessment of osteo-arthrosis. Ann Rheum Dis. 1957; 16(4):494-502. PMC: 1006995. DOI: 10.1136/ard.16.4.494. View

Bergink A, van der Klift M, Hofman A, Verhaar J, van Leeuwen J, Uitterlinden A . Osteoarthritis of the knee is associated with vertebral and nonvertebral fractures in the elderly: the Rotterdam Study. Arthritis Rheum. 2003; 49(5):648-57. DOI: 10.1002/art.11380. View

Dequeker J, Aerssens J, Luyten F . Osteoarthritis and osteoporosis: clinical and research evidence of inverse relationship. Aging Clin Exp Res. 2004; 15(5):426-39. DOI: 10.1007/BF03327364. View

Siris E, Chen Y, Abbott T, Barrett-Connor E, Miller P, Wehren L . Bone mineral density thresholds for pharmacological intervention to prevent fractures. Arch Intern Med. 2004; 164(10):1108-12. DOI: 10.1001/archinte.164.10.1108. View

Sandini L, Arokoski J, Jurvelin J, Kroger H . Increased bone mineral content but not bone mineral density in the hip in surgically treated knee and hip osteoarthritis. J Rheumatol. 2005; 32(10):1951-7. View

Atik O, Gunal I, Korkusuz F . Burden of osteoporosis. Clin Orthop Relat Res. 2006; 443:19-24. DOI: 10.1097/01.blo.0000200248.34876.fe. View

10.

Pasco J, Seeman E, Henry M, Merriman E, Nicholson G, Kotowicz M . The population burden of fractures originates in women with osteopenia, not osteoporosis. Osteoporos Int. 2006; 17(9):1404-9. DOI: 10.1007/s00198-006-0135-9. View

11.

Nguyen N, Eisman J, Center J, Nguyen T . Risk factors for fracture in nonosteoporotic men and women. J Clin Endocrinol Metab. 2006; 92(3):955-62. DOI: 10.1210/jc.2006-1476. View

12.

Kanis J, Burlet N, Cooper C, Delmas P, Reginster J, Borgstrom F . European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int. 2008; 19(4):399-428. PMC: 2613968. DOI: 10.1007/s00198-008-0560-z. View

13.

Kanis J, Johnell O, Oden A, Johansson H, McCloskey E . FRAX and the assessment of fracture probability in men and women from the UK. Osteoporos Int. 2008; 19(4):385-97. PMC: 2267485. DOI: 10.1007/s00198-007-0543-5. View

14.

Breijawi N, Eckardt A, Pitton M, Hoelzl A, Giesa M, von Stechow D . Bone mineral density and vitamin D status in female and male patients with osteoarthritis of the knee or hip. Eur Surg Res. 2008; 42(1):1-10. DOI: 10.1159/000166164. View

15.

Ding C, Cicuttini F, Boon C, Boon P, Srikanth V, Cooley H . Knee and hip radiographic osteoarthritis predict total hip bone loss in older adults: a prospective study. J Bone Miner Res. 2009; 25(4):858-65. DOI: 10.1359/jbmr.091012. View

16.

Lingard E, Mitchell S, Francis R, Rawlings D, Peaston R, Birrell F . The prevalence of osteoporosis in patients with severe hip and knee osteoarthritis awaiting joint arthroplasty. Age Ageing. 2009; 39(2):234-9. DOI: 10.1093/ageing/afp222. View

17.

Bijlsma J, Berenbaum F, Lafeber F . Osteoarthritis: an update with relevance for clinical practice. Lancet. 2011; 377(9783):2115-26. DOI: 10.1016/S0140-6736(11)60243-2. View

18.

Kanis J, McCloskey E, Johansson H, Oden A, Leslie W . FRAX(®) with and without bone mineral density. Calcif Tissue Int. 2011; 90(1):1-13. DOI: 10.1007/s00223-011-9544-7. View

19.

Kim K, Lee K, Ko Y, Kim S, Oh S, Durrance D . Prevalence, awareness, and treatment of osteoporosis among Korean women: The Fourth Korea National Health and Nutrition Examination Survey. Bone. 2012; 50(5):1039-47. DOI: 10.1016/j.bone.2012.02.007. View

20.

Bultink I, Vis M, van der Horst-Bruinsma I, Lems W . Inflammatory rheumatic disorders and bone. Curr Rheumatol Rep. 2012; 14(3):224-30. PMC: 3338911. DOI: 10.1007/s11926-012-0252-8. View