Clinical Orthopaedics and Related Research: April 2014 - Volume 472 - Issue 4 - p 1224–1229 doi: 10.1007/s11999-013-3395-7 Basic Research

Patients With Hip Osteoarthritis Have a Phenotype With High Bone Mass and Low Lean Body Mass

Karlsson, Magnus, K., MD, PhD1,a; Magnusson, Håkan, MD, PhD1; Cöster, Maria, C., MD1; vonSchewelov, Tord, MD, PhD1; Karlsson, Caroline, MD, PhD1; Rosengren, Björn, E., MD, PhD1
Ankle Elbow Hip Knee Shoulder

Background Although hip osteoarthritis (OA) is common, its etiology is poorly understood. Specifically, it is not known whether hip OA is associated with abnormal relationships among the anthropometric and musculoskeletal characteristics that are associated with OA in general.


Questions We asked whether patients with primary hip OA have a phenotype with higher bone mineral density (BMD), higher BMI, larger skeletal size, lower lean body mass, and higher fat content.


Material and Methods We included 30 women and 32 men (mean age, 66 years; range, 42-84 years) with primary hip OA and 96 women and 91 men as control subjects. Dual energy x-ray absorptiometry was used to measure total body BMD (g/cm2), femoral neck width (cm), fat and lean mass (%), and BMI (kg/m2). Z scores were calculated for each individual. Data are presented as means with 95% CI.


Results Women with hip OA had the following Z scores: total body BMD 0.6 (0.3, 1.0); BMI 0.6 (0.2, 1.0); femoral neck width 0.2 (−0.6, 1.0); percent total body lean mass −0.9 (−1.2, −0.5); and percent total body fat mass 0.6 (0.2, 0.9). Men with hip OA had the following mean Z scores: total body BMD 0.5 (0.0, 1.0); BMI 0.8 (0.3, 1.3); femoral neck width 0.4 (0.01, 0.9); percent total body lean mass −0.8 (−1.1, −0.5); and percent total body fat mass 0.5 (0.2, 0.8).


Conclusions Women and men with idiopathic hip OA have a phenotype with higher BMD, higher BMI, proportionally higher fat mass, and proportionally lower lean body mass. Men also have a larger skeletal size.


Clinical Relevance A higher BMD may lead to a stiffer bone and a proportionally lower lean body mass to lower joint-protective ability, both traits probably predisposing for hip OA.

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