Prevalence of osteoporosis in patients with knee osteoarthritis awaiting total knee arthroplasty is similar to that in the general population

Abstract Background Osteoporosis is common in patients with knee osteoarthritis (KOA) awaiting total knee arthroplasty (TKA) and varies in different regional and ethnic. However, it is unclear whether the prevalence of osteoporosis and osteopenia in these patients is different from that in the gener...

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Main Authors: Li Li, Rui Huang, Xiang Gao, Zhenxing Li, Yuanyuan Lin, Hanle Zhang, Yilun Jiang, Pei Fan
Format: Article
Language:English
Published: BMC 2025-03-01
Series:BMC Musculoskeletal Disorders
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Online Access:https://doi.org/10.1186/s12891-025-08389-2
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author Li Li
Rui Huang
Xiang Gao
Zhenxing Li
Yuanyuan Lin
Hanle Zhang
Yilun Jiang
Pei Fan
author_facet Li Li
Rui Huang
Xiang Gao
Zhenxing Li
Yuanyuan Lin
Hanle Zhang
Yilun Jiang
Pei Fan
author_sort Li Li
collection DOAJ
description Abstract Background Osteoporosis is common in patients with knee osteoarthritis (KOA) awaiting total knee arthroplasty (TKA) and varies in different regional and ethnic. However, it is unclear whether the prevalence of osteoporosis and osteopenia in these patients is different from that in the general population. This study aims to investigate the prevalence of osteoporosis and osteopenia in both populations to help exploring the relationship between the osteoporosis and osteoarthritis, and to explore whether knee function and radiological assessments of KOA are associated with osteoporosis. Methods In total, 249 patients diagnosed with KOA awaiting TKA were investigated in this cross-sectional study. The mean age was 70.9 ± 6.4 years. Bone mineral density (BMD) and T scores at the hip and lumbar spine were used to assess bone status using dual X-ray absorptiometry. A matched cohort from 2448 individuals in the Health Examination Center of our hospital was set as controls by matching sex, age (± 3.0 years) and BMI (± 1.0). The Kellgren-Lawrence grades (K-L grades), mechanical femorotibial angle (mFTA), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score and range of motion (ROM) of the knee were measured to evaluate radiological assessments and knee function in patients awaiting TKA and used to explore the association between KOA and BMD or T score. Prevalence of osteoporosis and osteopenia were investigated in the two cohorts, and inferential statistical analyses were undertaken. The chi-squared test or Fisher’s exact test was used for categorical variables while comparisons of scores were examined by ANOVA with/without Bonferroni correction or the Kruskal‒Wallis test. Results The prevalence of osteoporosis and osteopenia in patients awaiting TKA was 30.5% (76/249) and 44.2% (110/249), respectively. In the matched cohort, 72/249 (28.9%) had osteoporosis, while 98/249 (39.4%) had osteopenia. There was no significant difference in the prevalence of osteoporosis or osteopenia between the two groups (χ2 = 2.603, P = 0.272). mFTA was significantly correlated with BMD and T score (P < 0.05), while no correlation was found between K-L grade, ROM or WOMAC and BMD or T score (P > 0.05). Conclusions The prevalence of osteoporosis in patients awaiting TKA was similar to that in the general population. BMD and T score were not correlated with WOMAC score or K-L grade but were correlated with mFTA.
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spelling doaj-art-7c6d9dbfa47740b88d880d2352cf427b2025-08-20T03:05:55ZengBMCBMC Musculoskeletal Disorders1471-24742025-03-012611910.1186/s12891-025-08389-2Prevalence of osteoporosis in patients with knee osteoarthritis awaiting total knee arthroplasty is similar to that in the general populationLi Li0Rui Huang1Xiang Gao2Zhenxing Li3Yuanyuan Lin4Hanle Zhang5Yilun Jiang6Pei Fan7Key Laboratory of Pediatric Anesthesiology, Ministry of Education, Precision Anesthesiology Key Laboratory of Zhejiang Province, The Second Affiliated Hospital of Wenzhou Medical University, Yuying Children’S HospitalDepartment of Orthopedics, The Second Affiliated Hospital of Wenzhou Medical University, Yuying Children’S HospitalDepartment of Orthopedics, The Second Affiliated Hospital of Wenzhou Medical University, Yuying Children’S HospitalDepartment of Orthopedics, The Second Affiliated Hospital of Wenzhou Medical University, Yuying Children’S HospitalDepartment of Orthopedics, The Second Affiliated Hospital of Wenzhou Medical University, Yuying Children’S HospitalDepartment of Rehabilitation, The Second Affiliated Hospital of Wenzhou Medical University, Yuying Children’S HospitalDepartment of Orthopedics, The Second Affiliated Hospital of Wenzhou Medical University, Yuying Children’S HospitalDepartment of Orthopedics, The Second Affiliated Hospital of Wenzhou Medical University, Yuying Children’S HospitalAbstract Background Osteoporosis is common in patients with knee osteoarthritis (KOA) awaiting total knee arthroplasty (TKA) and varies in different regional and ethnic. However, it is unclear whether the prevalence of osteoporosis and osteopenia in these patients is different from that in the general population. This study aims to investigate the prevalence of osteoporosis and osteopenia in both populations to help exploring the relationship between the osteoporosis and osteoarthritis, and to explore whether knee function and radiological assessments of KOA are associated with osteoporosis. Methods In total, 249 patients diagnosed with KOA awaiting TKA were investigated in this cross-sectional study. The mean age was 70.9 ± 6.4 years. Bone mineral density (BMD) and T scores at the hip and lumbar spine were used to assess bone status using dual X-ray absorptiometry. A matched cohort from 2448 individuals in the Health Examination Center of our hospital was set as controls by matching sex, age (± 3.0 years) and BMI (± 1.0). The Kellgren-Lawrence grades (K-L grades), mechanical femorotibial angle (mFTA), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score and range of motion (ROM) of the knee were measured to evaluate radiological assessments and knee function in patients awaiting TKA and used to explore the association between KOA and BMD or T score. Prevalence of osteoporosis and osteopenia were investigated in the two cohorts, and inferential statistical analyses were undertaken. The chi-squared test or Fisher’s exact test was used for categorical variables while comparisons of scores were examined by ANOVA with/without Bonferroni correction or the Kruskal‒Wallis test. Results The prevalence of osteoporosis and osteopenia in patients awaiting TKA was 30.5% (76/249) and 44.2% (110/249), respectively. In the matched cohort, 72/249 (28.9%) had osteoporosis, while 98/249 (39.4%) had osteopenia. There was no significant difference in the prevalence of osteoporosis or osteopenia between the two groups (χ2 = 2.603, P = 0.272). mFTA was significantly correlated with BMD and T score (P < 0.05), while no correlation was found between K-L grade, ROM or WOMAC and BMD or T score (P > 0.05). Conclusions The prevalence of osteoporosis in patients awaiting TKA was similar to that in the general population. BMD and T score were not correlated with WOMAC score or K-L grade but were correlated with mFTA.https://doi.org/10.1186/s12891-025-08389-2Bone mineral densityPrevalence of osteoporosisOsteoarthritis of kneeArthroplasty
spellingShingle Li Li
Rui Huang
Xiang Gao
Zhenxing Li
Yuanyuan Lin
Hanle Zhang
Yilun Jiang
Pei Fan
Prevalence of osteoporosis in patients with knee osteoarthritis awaiting total knee arthroplasty is similar to that in the general population
BMC Musculoskeletal Disorders
Bone mineral density
Prevalence of osteoporosis
Osteoarthritis of knee
Arthroplasty
title Prevalence of osteoporosis in patients with knee osteoarthritis awaiting total knee arthroplasty is similar to that in the general population
title_full Prevalence of osteoporosis in patients with knee osteoarthritis awaiting total knee arthroplasty is similar to that in the general population
title_fullStr Prevalence of osteoporosis in patients with knee osteoarthritis awaiting total knee arthroplasty is similar to that in the general population
title_full_unstemmed Prevalence of osteoporosis in patients with knee osteoarthritis awaiting total knee arthroplasty is similar to that in the general population
title_short Prevalence of osteoporosis in patients with knee osteoarthritis awaiting total knee arthroplasty is similar to that in the general population
title_sort prevalence of osteoporosis in patients with knee osteoarthritis awaiting total knee arthroplasty is similar to that in the general population
topic Bone mineral density
Prevalence of osteoporosis
Osteoarthritis of knee
Arthroplasty
url https://doi.org/10.1186/s12891-025-08389-2
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