Bone Abstracts

Osteoarthritis (OA) and osteoporosis (OP) are two diseases characterized by the alteration of bone quality, that affect mainly elderly people reducing their quality of life. Although an inverse relationship between has been shown by some studies, other reports supported the co-existence of these pathologies. In this study we combined clinical and structural features to clarify the relationship between OA and OP.

Among all the patients who underwent a total hip Arthroplasty in our Hospital we selected 80 patients, divided into four groups according to BMD values and diagnosis, femoral neck fractures (n=20, mean age 79.7) or OA (n=60: 20 patients with normal BMD, 20 patients with osteopenic BMD and 20 patients with osteoporotic BMD; mean age 68.4 years).

We performed an X-ray of the hip to assess the OA severity through the Kellgren–Lawrence scale and we used HHS to evaluate the functionality of the hip and the clinical severity of OA.

During surgery, an osteotomy of the femoral head was performed and the samples were used for histomorphometry through Bio Quant software.

Histomorphometrical analysis showed that bone volume fraction was significantly lower in subjects with femoral neck fracture (19.98±4.72%) than subjects with non-osteopenic OA (31.19±5.47%; P<0.01) or osteopenic OA (28.45±5.77%; P<0.01), respectively. No difference between subjects with OP fractures and those with combined OA and OP (23.58±4.47%) was detected.

Our data supports evidence indicating impaired bone quality in patients with OA and the absence of the protective effect against OP. The worst bone quality in patients with the lowest HHS and the most surface macroscopic alterations suggests that severe OA can be related to OP especially in older patients. It could be useful to determine the presence of a condition of Poor Bone Quality in patients with severe OA who need surgery, to make an adequate pharmacological and surgical approach.