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Association of osteoporosis and varus inclination of the tibial plateau in postmenopausal women with advanced osteoarthritis of the knee

Authors
  • Wang, Shun-Ping1, 2
  • Wu, Po-Kuan1
  • Lee, Cheng-Hung1, 3
  • Shih, Cheng-Min1, 4, 3
  • Chiu, Yung-Cheng5, 6
  • Hsu, Cheng-En1, 2
  • 1 Taichung Veterans General Hospital, Taichung, Taiwan , Taichung (Taiwan)
  • 2 Tunghai University, Taichung, Taiwan , Taichung (Taiwan)
  • 3 Hung Kuang University, Taichung, Taiwan , Taichung (Taiwan)
  • 4 National Yang Ming Chiao Tung University, Hsinchu, Taiwan , Hsinchu (Taiwan)
  • 5 China Medical University, Taichung, Taiwan , Taichung (Taiwan)
  • 6 China Medical University Hospital, Taichung, Taiwan , Taichung (Taiwan)
Type
Published Article
Journal
BMC Musculoskeletal Disorders
Publisher
Springer (Biomed Central Ltd.)
Publication Date
Feb 25, 2021
Volume
22
Issue
1
Identifiers
DOI: 10.1186/s12891-021-04090-2
Source
Springer Nature
Keywords
License
Green

Abstract

BackgroundAlthough varus inclination of the tibial plateau has increasingly been recognized as a major risk factor in the progression of Osteoarthritis of the knee (OA knee), little attention has been placed on the development of the varus inclination of the tibial plateau. Osteoporosis is a disease characterized by low bone mass and may increase the risk of a stress fracture in the proximal tibia. To date, risk factors for varus inclination of the tibial plateau are rarely reported. In this study, we investigated Bone Mineral Density (BMD) as a risk factor of varus inclination of the tibial plateau in postmenopausal women with advanced OA knee.MethodsA total of 90 postmenopausal women with varus OA knee who had received a total knee arthroplasty in our department between January 2016 and December 2019 were reviewed. Certain factors may correlate to inclination of the tibial plateau (Medial Tibial Plateau Angle, MTPA), including age, operation side, Kellgren-Lawrence grade of OA knee, BMD, Body Mass Index (BMI), Lateral Distal Femur Angle (LDFA), lower extremity alignment (Hip-Knee-Ankle angle, HKAA), and history of both spinal compression fracture and hip fracture were collected and analyzed.ResultsOsteoporosis, lower extremity varus malalignment and age were significantly associated with varus inclination of the tibial plateau (MTPA) (P = 0.15, 0.013 and 0.033 respectively). For patients with a lower extremity varus malalignment (HKAA < 175°), osteoporosis (T-score ≤ -2.5) was significantly associated with inclination of the tibial plateau. For patients with a normal lower extremity alignment (HKAA ≥ 175°), no significant association was found between osteoporosis (T-score ≤ -2.5) and varus inclination of the tibial plateau.ConclusionsOsteoporosis, lower extremity varus malalignment and age are major risk factors for inclination of the tibial plateau in postmenopausal women with OA knee. More attention needs to be given to the progression of varus OA knee in postmenopausal women who simultaneously has osteoporosis and lower extremity varus malalignment.

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