The Journal of Bone and Joint Surgery, Vol 67, Issue 4 586-592, Copyright © 1985 by Journal of Bone and Joint Surgery, Inc
The coexistence and characteristics of osteoarthritis and osteoporosis
JH Healey, VJ Vigorita and JM Lane
We defined the clinical features and radiographic coexistence of
osteoarthritis and osteoporosis in fifty women with primary coxarthrosis
and fifty age-matched women (average age, 69 +/- 5 years) with idiopathic
osteoporosis. The patients with osteoarthritis had undergone total hip
replacement. The diagnosis of primary osteoarthritis was established by
clinical, radiographic, and histological criteria, and the diagnosis of
osteoporosis was confirmed by histomorphometric analysis of specimens taken
at iliac-bone biopsy. In the arthritic patients, spinal osteoporosis was
identified by radiographic evidence of compression fractures, kyphosis, and
scoliosis. Femoral osteoporosis was demonstrated by the index of Singh et
al. and the femoral canal-shaft ratio. In the osteoporotic patients
coxarthrosis was measured radiographically by the scale of Kellgren and
Lawrence. On the average, the osteoporotic patients were twelve kilograms
lighter than the osteoarthritic patients. Fifty-eight per cent of the
osteoporotic and 18 per cent of the osteoarthritic patients had a scoliotic
curve of at least 10 degrees. The prevalence of osteoarthritis of the hip
in the osteoporotic women was 4 per cent, and the prevalence of compression
fractures in the arthritic women was 6 per cent, which was approximately
one-quarter of the expected incidence. These results show that: (1)
osteoporosis does not protect against the development of coxarthrosis, (2)
coxarthrosis is a negative risk factor for osteoporotic compression
fractures, and (3) scoliosis and an ectomorphic habitus are clinical
markers that identify a risk for osteoporosis.(ABSTRACT TRUNCATED AT 250
WORDS)