DOS 2016

DOS Kongressen 2016 ·

Bone mass is lower in patients with severe knee

osteoarthritis and attrition.

Karina Nørgaard Linde, Katriina Bøcker Puhakka, Bente Lomholt Langdahl, Kjeld

Søballe, Inger Krog-Mikkelsen, Maiken Stilling

Orthopedic Research Unit and Department of Clinical Medicine, Aarhus University

Hospital and Aarhus University, Denmark; Department of Radiology, Aarhus University

Hospital, Denmark; Department of Endocrinology and Internal Medicine, Aarhus

University Hospital, Denmark; Department of Orthopaedic Surgery and Department

of Clinical Medicine, Aarhus University Hospital and Department of Clinical Medicine,

Aarhus University, Denmark; Orthopedic Research Unit, Aarhus University Hospital,

Denmark; Department of Clinical Medicine, Aarhus University, Denmark

Background:

Bone quality is probably important for the survival of knee arthroplasty

(KA), however little is known about preoperative bone mass, bone turnover and vitamin

D status.

Purpose / Aim of Study:

To explore the prevalence of osteoporosis and preoperative

bone turnover in relation to knee osteoarthritis (OA) grade in patients scheduled for KA.

Materials and Methods:

Prospective preoperative evaluation of patients with OA

scheduled for KA between 2014- 2016. 475 patients (281 females) were examined

with standing knee radiography, DXA (BMD lowest T-score of hip or spine), and bio-

markers for bone turnover (CTX, P1NP) and vitamin D. OA grading on the first 184 pa-

tients was made in consensus with an experienced radiologist by use of the Altman Atlas

(AA). Grading is currently ongoing towards the full cohort.

Findings / Results:

Mean patient age was 67.8 years (CI95 66.8;68.8). The proportion

of patients with osteoporosis (OP) was 10.2% (CI95 7.4;12.9), while the proportion of

patients with osteopenia was 36.2% (CI95 32.0; 40.7). Mean BMD T-score was 0.7

lower in women than in men (p<0.0001). After adjustment for age mean BMD T-score

was 0.44 (CI95 0.05;0.83) lower when attrition (AA) was present medially or later-

ally compared to not present (p=0.026). Altman total grade and CTX and P1NP had a

weak but significant correlation (p<0.001). After adjustment for age P1NP was 11%

higher (p=0.16) when attrition (AA) was present compared to not present. No differ-

ence in CTX with the presence of attrition (p=0.53). Serum vitamin D was 78.9 (CI95

76.1;81.7) nmol/L. There was no association between vitamin D and AA grade (p>0.34).

Conclusions:

Bone mass was lower with severe knee osteoarthritis (attrition). There

was a trend towards higher bone turnover biomarker (P1NP) with higher grade of knee

osteoarthritis. 10% of patients had osteoporosis.

No conflicts of interest reported

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