Yasuhiro Ishidou and Kanehiro Matsuyama contributed equally to this work.
As elderly patients with hip osteoarthritis aged, acetabular dysplasia parameters decreased (Sharp’s angle, acetabular roof obliquity angle, and acetabular head index) and the incidence of the atrophic type increased. Vertebral body fracture was more frequent in the atrophic type, suggesting the involvement of osteoporosis at the onset of hip osteoarthritis.
Osteoarthritis (OA) is associated with increased bone formation at a local site. However, excessive bone resorption has also been found to occur in the early stages of OA. Osteoporosis may be involved in the onset of OA in elderly patients. We conducted a cross-sectional radiographic study of patients with hip OA and examined the association between age and factors of acetabular dysplasia (Sharp’s angle, acetabular roof obliquity angle, and acetabular head index) as well as the osteoblastic response to determine the potential involvement of osteoporosis.
This study included 366 patients (58 men, 308 women) who had undergone total hip arthroplasty for the diagnosis of hip OA. We measured the parameters of acetabular dysplasia using preoperative frontal X-ray images and evaluated each patient according to Bombelli classification of OA (hypertrophic, normotrophic, or atrophic type).
As the patients aged, the parameters of acetabular dysplasia decreased. The incidence of the atrophic type of OA was significantly higher in older patients. Vertebral body fractures were more frequent in the atrophic type than in the other types. Additionally, the index of acetabular dysplasia was lower in the atrophic type. By contrast, the hypertrophic type was present in relatively younger patients and was associated with an increased index of acetabular dysplasia.
In elderly patients with hip OA, the parameters of acetabular dysplasia decreased and the incidence of the atrophic type increased as the patients aged. The frequency of vertebral body fracture was high in patients with the atrophic type, suggesting the involvement of osteoporosis in the onset of hip OA.
Li ZC, Dai LY, Jiang LS, Qiu S (2012) Difference in subchondral cancellous bone between postmenopausal women with hip osteoarthritis and osteoporotic fracture: implication for fatigue microdamage, bone microarchitecture, and biomechanical properties. Arthritis Rheum 64:3955–3962. doi: 10.1002/art.34670 CrossRefPubMed
Bellido M, Lugo L, Roman-Blas JA, Castañeda S, Caeiro JR, Dapia S, Calvo E, Largo R, Herrero-Beaumont G (2010) Subchondral bone microstructural damage by increased remodelling aggravates experimental osteoarthritis preceded by osteoporosis. Arthritis Res Ther 12:R152. doi: 10.1186/ar3103 CrossRefPubMedPubMedCentral
Mohan G, Perilli E, Parkinson IH, Humphries JM, Fazzalari NL, Kuliwaba JS (2013) Pre-emptive, early, and delayed alendronate treatment in a rat model of knee osteoarthritis: effect on subchondral trabecular bone microarchitecture and cartilage degradation of the tibia, bone/cartilage turnover, and joint discomfort. Osteoarthr Cartil 21:1595–1604. doi: 10.1016/j.joca.2013.06.020 CrossRefPubMed
Solomon L (1976) Patterns of osteoarthritis of the hip. J Bone Joint Surg Br 58:176–183 PubMed
Conrozier T, Merle-Vincent F, Mathieu P, Richard M, Favret H, Piperno M, Caton J, Vignon E (2004) Epidemiological, clinical, biological and radiological differences between atrophic and hypertrophic patterns of hip osteoarthritis: a case-control study. Clin Exp Rheumatol 22:403–408 PubMed
Jingushi S, Ohfuji S, Sofue M, Hirota Y, Itoman M, Matsumoto T, Hamada Y, Shindo H, Takatori Y, Yamada H, Yasunaga Y, Ito H, Mori S, Owan I, Fujii G, Ohashi H, Iwamoto Y, Miyanishi K, Iga T, Takahira N, Sugimori T, Sugiyama H, Okano K, Karita T, Ando K, Hamaki T, Hirayama T, Iwata K, Nakasone S, Matsuura M, Mawatari T (2011) Osteoarthritis hip joints in Japan: involvement of acetabular dysplasia. J Orthop Sci 16:156–164. doi: 10.1007/s00776-011-0025-7 CrossRefPubMed
Jingushi S, Ohfuji S, Sofue M, Hirota Y, Itoman M, Matsumoto T, Hamada Y, Shindo H, Takatori Y, Yamada H, Yasunaga Y, Ito H, Mori S, Owan I, Fujii G, Ohashi H, Iwamoto Y, Miyanishi K, Iga T, Takahira N, Sugimori T, Sugiyama H, Okano K, Karita T, Ando K, Hamaki T, Hirayama T, Iwata K, Nakasone S, Matsuura M, Mawatari T (2010) Multiinstitutional epidemiological study regarding osteoarthritis of the hip in Japan. J Orthop Sci 15:626–631. doi: 10.1007/s00776-010-1507-8 CrossRefPubMed
Sharp IK (1961) Acetabular dysplasia. The acetabular angle. J Bone Joint Surg Br 43:268–272
Takatori Y, Ito K, Sofue M, Hirota Y, Itoman M, Matsumoto T, Hamada Y, Shindo H, Yamada H, Yasunaga Y, Ito H, Mori S, Owan I, Fujii G, Ohashi H, Mawatari T, Iga T, Takahira N, Sugimori T, Sugiyama H, Okano K, Karita T, Ando K, Hamaki T, Hirayama T, Iwata K, Matsuura M, Jingushi S (2010) Analysis of interobserver reliability for radiographic staging of coxarthrosis and indexes of acetabular dysplasia: a preliminary study. J Orthop Sci 15:14–19. doi: 10.1007/s00776-009-1412-1 CrossRefPubMed
Bombelli R (1983) Osteoarthritis of the hip: classification and pathogenesis: the role of osteotomy as a consequent therapy, 2nd edn. Springer, Berlin
Saito M, Saito S, Ohzono K, Ono K (1987) The osteoblastic response to osteoarthritis of the hip. Its influence on the long-term results of arthroplasty. J Bone Joint Surg Br 69:746–751
Nishii T, Tamura S, Shiomi T, Yoshikawa H, Sugano N (2013) Alendronate treatment for hip osteoarthritis: prospective randomized 2-year trial. Clin Rheumatol 32:1759–1766. doi: 10.1007/s10067013-2338-8
Li G, Yin J, Gao J, Cheng TS, Pavlos NJ, Zhang C, Zheng MH (2013) Subchondral bone in osteoarthritis: insight into risk factors and microstructural changes. Arthritis Res Ther 15:223
Lane NE, Lin P, Christiansen L, Gore LR, Williams EN, Hochberg MC, Nevitt MC (2000) Association of mild acetabular dysplasia with an increased risk of incident hip osteoarthritis in elderly white women: the study of osteoporotic fractures. Arthritis Rheum 43:400–404
Okano K, Aoyagi K, Chiba K, Motokawa S, Matsumoto T (2011) Bone mineral density is not related to osteophyte formation in osteoarthritis of the hip. J Rheumatol 38:358–361. doi: 10.3899/jrheum.100533
- Osteoarthritis of the hip joint in elderly patients is most commonly atrophic, with low parameters of acetabular dysplasia and possible involvement of osteoporosis
- Springer London
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