Men's Osteoporosis Support GroupKnee or hip osteoarthritis as a risk factor for osteoporosis and a new segment for the website J Bone Miner Res. 2009 Oct 12. Epub 2009 Oct 12. Knee and Hip Radiographic Osteoarthritis Predict Total Hip Bone Loss in Older Adults: A Prospective Study.Ding C and others. PMID: 19821767. This study followed the progression of knee and hip osteoarthritis (OA) in 867 individuals with a mean age of 62 years, 49% female, for a 2.6 year period. In this case osteoarthritis was defined as joint space narrowing (JSN) or the presence of osteophytes with a measurable score of >0. It was found that increases in JSN and/or osteophytes, with or without pain, correlated with loss of hip bone mineral density (BMD) such that the authors could predict the hip BMD change based upon the JSN and osteophytes change. The authors concluded, " . . . older subjects with radiographic hip and knee OA have higher total hip bone loss over 2.6 years regardless of symptoms suggesting that consideration should be given to the monitoring of bone mass in these subjects." Editor's comments. These findings point to another risk factor that should spur individuals to ask for BMD testing: radiographically diagnosed knee and/or hip OA. The interesting factor is that it didn't matter whether the individual was in pain from the OA. There was reduced BMD even if there was no pain. Logically one could expect people to reduce their walking/jogging, or other weight-bearing exercise, if their OA caused knee or hip pain. That would then be expected to lead to reduced hip BMD. But why would OA correlate with decreased BMD in asymptomatic individuals? I don't have an answer. One problem I see with the study is that there are no controls, people of similar age, gender, exercise patterns, etc., with no radiographic evidence of OA, who also had their hip BMD measured over the same time span. Would they have also lost BMD? Until we have more answers, it is probably wise to assume that your hip or knee OA is evidence enough to make you ask for BMD testing if you've not had that done previously. New website feature. Today I posted the first article in a new segment of the website called Osteoporosis Issues. From time to time I plan on posting rather lengthy articles that include comprehensive literature reviews and discussion of complex and controversial issues that exist within the science of osteoporosis. This might include such topics as bone density as a proxy for fracture risk, safety of osteoporosis medications, effectiveness of osteoporosis medications, definition of osteoporosis, and the first edition, A low-acid, alkaline-forming diet to improve bone health.
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