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The association of subchondral and systemic bone mineral density with osteoarthritis-related joint replacements in older adults

Objective: To describe the association of subchondral and systemic bone mineral density (BMD) with knee and hip replacements (KR and HR, respectively) due to osteoarthritis.

Design: 1,095 participants (mean age 63 years, 51% female) were included. At baseline, subchondral BMD of the medial and lateral tibia in three regions of interest (ROI) for the right knee, and systemic BMD of the lumbar spine, femoral neck, total hip and whole-body, were measured using dual-energy X-ray absorptiometry. Subchondral BMD of the hip was not measured. Competing risk regression models were used to estimate sub-distribution hazard ratios (SHRs) of KR/HR per one standard deviation (SD) higher in BMD measures, with adjustment of potential confounders.

Results: Over 12.2 years, 79 (7.2%) participants underwent a KR and 56 (5.1%) an HR due to osteoarthritis. For the right side, medial subchondral BMD in ROI-3 was associated with an increased risk of KR (SHR 1.95 per SD; 95% Confidence Interval [CI], 1.57 to 2.43). In contrast, systemic BMD was not associated with the risk of KR, but higher BMD at the lumbar spine (1.42, 1.07 to 1.88) and whole-body (1.29, 1.00 to 1.66) were associated with an increased risk of HR at both sides.

Conclusions: Subchondral BMD is positively associated with an increased risk of KR and systemic BMD with an increased risk of HR, suggesting a role of BMD in the progression of osteoarthritis.

History

Publication title

Osteoarthritis and Cartilage

Volume

28

Issue

4

Pagination

438-445

ISSN

1063-4584

Department/School

Menzies Institute for Medical Research

Publisher

W B Saunders Co Ltd

Place of publication

32 Jamestown Rd, London, England, Nw1 7By

Rights statement

Copyright 2020 Osteoarthritis Research Society International

Repository Status

  • Restricted

Socio-economic Objectives

Clinical health not elsewhere classified

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