Summary
It is unclear whether patients with knee osteoarthritis (OA) and hip OA differ regarding soft tissue composition and bone mineral density (BMD). A total of 42 women waiting for a replacement of the hip (n=20) or the knee (n=22) due to OA were examined. Fat mass (FM), percent body fat (%fat), lean mass (LM) and BMD were measured by dual energy X-ray absorptiometry (DEXA). Knee extensor and flexor strength was measured by an isokinetic dynamometer. No significant differences in age, height, disease duration, Lequesne score or pain scores were found between the groups. Comparing the radiographic changes of the knees with those of the hips, changes were most severe in the joints which were to be replaced. Body weight, body mass index, total and regional FM, and %fat were more than 15% higher in patients waiting for a knee replacement (p<0.001). Also lean mass tended to be higher in the knee patients. Differences in BMD did not remain statistically significant after correction for body weight. Muscle strength was similar in the two groups but was reduced by 20% in the legs in which the joint was to be replaced compared to the contralateral legs. However, the mean difference in lean mass between the two legs was only 3% (p<0.05). The scores for pain felt during strength testing were significantly higher for the involved legs than for the contralateral legs. In conclusion, fat mass values were considerably higher in patients scheduled for a knee replacement. Impaired strength performance in OA may be more strongly associated with pain than with reduced muscle mass.
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References
Felson DT. Weight and osteoarthritis. J Rheumatol 1995; 43 (suppl): 7–9.
Spector TD, Hart DJ, Doyle DV. Incidence and progression of osteoarthritis in women with unilateral knee disease in the general population: the effect of obesity. Ann Rheum Dis 1994; 53: 565–9.
Davis MA, Ettinger WH, Neuhaus JM, Cho SA, Hauck WW. The association of knee injury and obesity with unilateral and bilateral osteoarthritis of the knee. Am J Epidemiol 1989; 130: 278–288.
Hart D, Spector TD. The relationship of obesity, fat distribution and osteoarthritis in the general population: The Chingford Study. J Rheumatol 1993; 20: 331–5.
Felson DT, Anderson JJ, Naimark A, Walker AM, Meenan RF. Obesity and knee osteoarthritis. The Framingham study. Ann Intern Med 1988; 109: 18–24.
Dougados M, Gueguen A, Nguyen M, Thiesce A, Listrat V, Jacob L, Nakache J-P, Gabriel KR, Lequesne M, Amor B. Longitudinal radiologic evaluation of osteoarthritis of the knee. J Rheumatol 1992; 19: 378–84.
Heliövaara M, Mäkelä M, Impivaara O, Aromaa A, Sievers K. Association of overweight, trauma and workload with coxarthrosis. Acta Orthop Scand 1993; 64: 513–8.
Tepper S, Hochberg MC. Factors associated with hip osteoarthritis: Data from the First National Health and Nutrition Examination Survey (NHANES-I). Am J Epidemiol 1993; 137: 1081–1088.
Vingård E. Overweight predisposes to coxarthrosis. Body mass index studied in 239 males with hip arthroplasty. Acta Orthop Scand 1991; 62: 106–109.
Felson DT. Epidemiology of hip and knee osteoarthritis. Epidemiol Rev 1988; 10: 1–28.
Hordon LD, Stewart SP, Troughton PR, Wright V, Horsman A, Smith MA. Primary generalized osteoarthritis and bone mass. Br J Rheum 1993; 32: 1059–61.
Hannan MT, Andersson JJ, Zhang Y, Levy D, Felson T. Bone mineral density and knee osteoarthritis in elderly men and women. The Framingham Study. Arthritis Rheum 1993; 12: 1671–80.
Haarbo J, Gotfredsen A, Hassager C, Christiansen C. Validation of body composition by dual energy X-ray absorptiometry (DEXA). Clin Physiol 1991; 11: 331–41.
Mazess RB, Barden HS, Bisek JP, Hanson J. Dual-energy X-ray absorptiometry for total body and regional bone-mineral and body-composition. Am J Clin Nutr 1990; 51: 1106–12.
Madsen OR, Hartkopp A, Sylvest J, Sørensen OH. Bone mass, regional lean mass and muscle strength in female athletes exposed to different skeletal loading patterns. Eur J Exp Musculoskel Res 1995; 4: 117–24.
González D, Mazure C, Vazquez H, Bai J. Body composition and bone mineral density in untreated and treated patients with celiac disease. Bone 1995; 16: 231–4.
Salamone LM, Glynn N, Black D, Epstein RS, Palermo L, Meilahn E, Kuller LH, Cauley JA. Body composition and bone mineral density in premenopausal and early perimenopausal women. J Bone Miner Res 1995; 10: 1762–8.
Madsen OR, Schaadt O, Bliddal H, Egsmose C, Sylvest J. Isometric and isokinetic quadriceps strength in gonarthrosis. Interrelations between quadriceps strength, walking ability, radiology, subchondral bone density and pain. Clin Rheumatol 1995; 14: 308–314.
Lankhorst GJ, Van de Stadt RJ, Van der Korst JK. The relationships of functional capacity, pain, and isometric and isokinetic torque in osteoarthrosis of the knee. Scand J Rehab Med 1985; 17: 167–72.
Madsen OR, Brot C. Assessment of extensor and flexor strength in the individual gonarthrotic patient. Interpretation of performance changes. Clin Rheumatol 1996; 15: 154–60.
Lequesne MG, Mery C, Samson M, Gerard P. Indexes of severity for osteoarthritis of the hip and knee. Scand J Rheum 1987; Suppl. 65: 85–9.
Cushnaghan J, Dieppe P. Study of 500 patients with limb joint osteoarthritis. I. Analysis by age, sex, and distribution of symptomatic joint sites. Ann Rheum Dis 1991; 50: 8–13.
Radin EL, Paul IL, Rose RM. The role of mechanical factors in pathogenesis of primary osteoarthritis. Lancet 1972; 1: 519–22.
Hassager C, Christiansen C. Influence of soft tissue body composition on bone mass and metabolism. Bone 1989; 10: 415–9.
Davis MA, Neuhaus JM, Ettinger WH, Mueller WH. Body fat distribution and osteoarthritis. Am J Epidemiol 1990; 132: 701–707.
Radin EL. Mechanical aspects of osteoarthritis. Bull Rheum Dis 1976; 26: 862–5.
Madsen OR, Schaadt O, Bliddal H, Egsmose C, Sylvest J. Bone mineral distribution of the proximal tibia in gonarthrosis assessed in vivo by photon absorption. Osteoarthritis Cartilage 1994; 2: 141–7.
Roh YS, Dequeker J, Mulier JC. Bone mass in osteoarthritis, measured in vivo by photon absorption. J Bone Joint Surg [Am] 1974; 56: 587–91.
Petersen MM, Olsen C, Lauritzen JB, Lund B. Bone mineral content assessed by dual photon absorptiometry in the proximal tibia: normative data and measurements in orthopedic conditions. Eur J Exp Musculoskel Res 1993; 2: 121–6.
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Madsen, O.R., Brot, C., Petersen, M.M. et al. Body composition and muscle strength in women scheduled for a knee or hip replacement. A comparative study of two groups of osteoarthritic women. Clin Rheumatol 16, 39–44 (1997). https://doi.org/10.1007/BF02238761
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DOI: https://doi.org/10.1007/BF02238761