Tarantino U
Scientific Tracks Abstracts: Rheumatology & Orthopedics
O steoarthritis (OA) and osteoporosis (OP) are diseases with multifactorial etiology, both characterized by an alteration of Bone Quality and a reduced life quality. Although an inverse relationship between OA and OP has been already shown by some studies, other reports supported the co-existence of the two diseases. We aimed at clarifying the relationship between OA and OP by combining both clinical (Harris Hip Score, HHS) and structural features (BMD and bone histomorphometry). BMD and bone quality (using bone histomorphometry) were assessed in 80 consecutive patients undergoing hip arthroplasty for osteoporotic femoral fractures (n=20, mean age 79.7 [FX-OP]) or severe OA with different BMD values (n=60, mean age 68.4 years; 20 patients with normal BMD [OA-n]; 20 patients with osteopenic BMD [OA-op]; 20 patients with osteoporotic BMD [OA-OP]). A radiographic evaluation of the pelvis and HHS were also performed in all studied subjects. During surgery, a macroscopic evaluation of the surface alterations and a double osteotomy of the femoral heads were performed and the samples were used for histomorphometry using the Bio Quant Osteo software. Histomorphometrical analysis showed that the bone volume fraction (BV/TV) was significantly lower in subjects with femoral neck fractures (19.98�4.72%) compared with 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 was detected between subjects with OP fractures and those with combined OA and OP (23.58�4.47%). Similar data regarding the thickness, number and distance between the trabeculae was collected from trabecular analysis. Moreover, clinical scores tended to be associated with BMD and histomorphometric features. In cases of lower HHS, we also found lower BMD and BV/TV values. Macroscopic evaluation of the femoral heads detected more surface alterations in the OA-OP group than in the other groups. In conclusion, 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
