Bone and cartilage characteristics in postmenopausal women with mild knee radiographic osteoarthritis and those without radiographic osteoarthritis

Objectives: To evaluate the association between radiographically-assessed knee osteoarthritis and femoral neck bone characteristics in women with mild knee radiographic osteoarthritis and those without radiographic osteoarthritis. Methods: Ninety postmenopausal women (mean age [SD], 58 [4] years; height, 163 [6] cm; weight, 71 [11] kg) participated in this cross-sectional study. The severity of radiographic knee osteoarthritis was defined using Kellgren-Lawrence grades 0=normal (n=12), 1=doubtful (n=25) or 2=minimal (n=53). Femoral neck bone mineral content (BMC), section modulus (Z), and cross-sectional area (CSA) were measured with DXA. The biochemical composition of ipsilateral knee cartilage was estimated using quantitative MRI measures, T2 mapping and dGEMRIC. The associations between radiographic knee osteoarthritis grades and bone and cartilage characteristics were analyzed using generalized linear models. Results: Age-, height-, and weight-adjusted femoral neck BMC (p for linearity=0.019), Z (p for linearity=0.033), and CSA (p for linearity=0.019) increased significantly with higher knee osteoarthritis grades. There was no linear relationship between osteoarthritis grades and knee cartilage indices. Conclusions: Increased DXA assessed hip bone strength is related to knee osteoarthritis severity. These results are hypothesis driven that there is an inverse relationship between osteoarthritis and osteoporosis. However, MRI assessed measures of cartilage do not discriminate mild radiographic osteoarthritis severity.

[1]  D. Heinegård,et al.  Altered patterns and synthesis of extracellular matrix macromolecules in early osteoarthritis. , 2004, Matrix biology : journal of the International Society for Matrix Biology.

[2]  J. Matyas,et al.  The early molecular natural history of experimental osteoarthritis. I. Progressive discoordinate expression of aggrecan and type II procollagen messenger RNA in the articular cartilage of adult animals. , 1999, Arthritis and rheumatism.

[3]  F. Cicuttini,et al.  Association between knee cartilage volume and bone mineral density in older adults without osteoarthritis. , 2004, Rheumatology.

[4]  R. Ojala,et al.  Reproducibility of imaging human knee cartilage by delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) at 1.5 Tesla. , 2009, Osteoarthritis and cartilage.

[5]  J. Jurvelin,et al.  Bone mineral density in the proximal femur and contralateral knee after total knee arthroplasty. , 2004, Journal of clinical densitometry : the official journal of the International Society for Clinical Densitometry.

[6]  J. Arokoski,et al.  Increased bone mineral content and bone size in the femoral neck of men with hip osteoarthritis , 2002, Annals of the rheumatic diseases.

[7]  F. Cicuttini,et al.  Bone mineral density is cross sectionally associated with cartilage volume in healthy, asymptomatic adult females: Geelong Osteoporosis Study. , 2011, Bone.

[8]  Bruce C. Po,et al.  Glycosaminoglycan distribution in cartilage as determined by delayed gadolinium-enhanced MRI of cartilage (dGEMRIC): potential clinical applications. , 2004, AJR. American journal of roentgenology.

[9]  S. Cummings,et al.  Radiographic osteoarthritis of the hip and bone mineral density. The Study of Osteoporotic Fractures Research Group. , 1995, Arthritis and rheumatism.

[10]  L. Price,et al.  Cross-sectional DXA and MR measures of tibial periarticular bone associate with radiographic knee osteoarthritis severity. , 2012, Osteoarthritis and cartilage.

[11]  T. Spector,et al.  The relationship between osteoarthritis and osteoporosis in the general population: the Chingford Study. , 1994, Annals of the rheumatic diseases.

[12]  J. Dequeker,et al.  Osteoporosis and osteoarthritis (osteoarthrosis). Anthropometric distinctions. , 1983 .

[13]  P. Era,et al.  Effects of strength and endurance training on isometric muscle strength and walking speed in elderly women. , 1996, Acta physiologica Scandinavica.

[14]  R. Schneiderman,et al.  Some biochemical and biophysical parameters for the study of the pathogenesis of osteoarthritis: a comparison between the processes of ageing and degeneration in human hip cartilage. , 1989, Connective tissue research.

[15]  Carl Johan Tiderius,et al.  Delayed gadolinium‐enhanced MRI of cartilage (dGEMRIC) in early knee osteoarthritis , 2003, Magnetic resonance in medicine.

[16]  D. Burstein,et al.  Nondestructive imaging of human cartilage glycosaminoglycan concentration by MRI , 1999, Magnetic resonance in medicine.

[17]  Daniel Levy,et al.  Bone mineral density and knee osteoarthritis in elderly men and women. The Framingham Study. , 1993, Arthritis and rheumatism.

[18]  A. Hofman,et al.  Association of radiographically evident osteoarthritis with higher bone mineral density and increased bone loss with age. The Rotterdam Study. , 1996, Arthritis and rheumatism.

[19]  F. Cicuttini,et al.  302 BONE MINERAL DENSITY IS CROSS SECTIONALLY ASSOCIATED WITH CARTILAGE VOLUME IN HEALTHY, ASYMPTOMATIC ADULT FEMALES: GEELONG OSTEOPOROSIS STUDY , 2011 .

[20]  K. Kaufman,et al.  Clinical evaluation of T2 values of patellar cartilage in patients with osteoarthritis. , 2007, Osteoarthritis and cartilage.

[21]  C. Goldsmith,et al.  Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. , 1988, The Journal of rheumatology.

[22]  Seong-Ho Kim,et al.  Knee osteoarthritis is associated with increased prevalence of vertebral fractures despite high systemic bone mineral density: a cross-sectional study in an Asian population , 2013, Modern rheumatology.

[23]  J. Kellgren,et al.  Radiological Assessment of Osteo-Arthrosis , 1957, Annals of the rheumatic diseases.

[24]  R. Laukkanen,et al.  Prediction of change in maximal aerobic power by the 2-km walk test after walking training in middle-aged adults. , 2000, International journal of sports medicine.

[25]  Thomas J Beck,et al.  Extending DXA beyond bone mineral density: Understanding hip structure analysis , 2007, Current osteoporosis reports.

[26]  D. Heinegård,et al.  Is cartilage sGAG content related to early changes in cartilage disease? Implications for interpretation of dGEMRIC. , 2012, Osteoarthritis and cartilage.

[27]  G. Im,et al.  The relationship between osteoarthritis and osteoporosis , 2014, Journal of Bone and Mineral Metabolism.

[28]  Jacob Cohen.  Statistical Power Analysis for the Behavioral Sciences , 1969, The SAGE Encyclopedia of Research Design.

[29]  M. Sowers,et al.  The associations of bone mineral density and bone turnover markers with osteoarthritis of the hand and knee in pre- and perimenopausal women. , 1999, Arthritis and rheumatism.

[30]  S Majumdar,et al.  In vivo T(1rho) and T(2) mapping of articular cartilage in osteoarthritis of the knee using 3 T MRI. , 2007, Osteoarthritis and cartilage.

[31]  H. Alaranta,et al.  The test–retest reliability of motor performance measures after traumatic brain injury , 2006 .

[32]  Y. Xia,et al.  Quantitative in situ correlation between microscopic MRI and polarized light microscopy studies of articular cartilage. , 2001, Osteoarthritis and cartilage.

[33]  Miika T Nieminen,et al.  Evaluation of chondral repair using quantitative MRI , 2012, Journal of magnetic resonance imaging : JMRI.

[34]  L. Price,et al.  Relationship of bone mineral density to progression of knee osteoarthritis. , 2013, Arthritis and rheumatism.

[35]  L. Sharma,et al.  dGEMRIC as a function of BMI. , 2006, Osteoarthritis and cartilage.

[36]  K. Aoyagi,et al.  Discrepancy in bone mineral densities at different skeletal sites in hip osteoarthritis patients , 2014, Modern rheumatology.

[37]  P. Komi,et al.  Neuromuscular performance and body mass as indices of bone loading in premenopausal and postmenopausal women. , 2010, Bone.

[38]  David R Bassett,et al.  2011 Compendium of Physical Activities: a second update of codes and MET values. , 2011, Medicine and science in sports and exercise.

[39]  M. H. McDonald Blumer.  Bone mineral content versus bone density in a population with osteoarthritis: a new twist to the controversy? , 2005, The Journal of rheumatology.

[40]  W. Horton,et al.  Intrajoint comparisons of gene expression patterns in human osteoarthritis suggest a change in chondrocyte phenotype , 2005, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[41]  W. Richter,et al.  Early and stable upregulation of collagen type II, collagen type I and YKL40 expression levels in cartilage during early experimental osteoarthritis occurs independent of joint location and histological grading , 2004, Arthritis research & therapy.

[42]  Charles A McKenzie,et al.  Delayed gadolinium-enhanced magnetic resonance imaging of cartilage in knee osteoarthritis: findings at different radiographic stages of disease and relationship to malalignment. , 2005, Arthritis and rheumatism.

[43]  David B. Burr,et al.  Bone remodelling in osteoarthritis , 2012, Nature Reviews Rheumatology.

[44]  R. Ojala,et al.  Effects of High‐Impact Training on Bone and Articular Cartilage: 12‐Month Randomized Controlled Quantitative MRI Study , 2014, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[45]  K. Nakashima,et al.  [The Rotterdam study]. , 2011, Nihon rinsho. Japanese journal of clinical medicine.

[46]  T. Dawber,et al.  The Framingham Study , 2014 .

[47]  S Majumdar,et al.  Quantitative magnetic resonance imaging of articular cartilage in osteoarthritis. , 2007, European cells & materials.

[48]  S. Majumdar,et al.  T2 relaxation time of cartilage at MR imaging: comparison with severity of knee osteoarthritis. , 2004, Radiology.

[49]  D. Burstein,et al.  Gd‐DTPA2− as a measure of cartilage degradation , 1996, Magnetic resonance in medicine.

[50]  M. Blumer.  Bone mineral content versus bone density in a population with osteoarthritis: a new twist to the controversy? , 2005 .

[51]  F. Luyten,et al.  Osteoarthritis and osteoporosis: Clinical and research evidence of inverse relationship , 2003, Aging clinical and experimental research.