The Study Of Relationship Between Varus Deformity Of Knee Osteoarthritis And Osteoporosis In Postmenopausal Women

ObjectiveVarus deformity of the knee is a common pathological characteristic in knee osteoarthritis(KOA),and not enough attention has been given to the relationship between knee varus deformity and the state of systemic bone mass.To explore the relationship between varus deformity and osteoporosis in postmenopausal women with knee osteoarthritis by measuring bone mineral density and different angles of limb alignment.MethodsRetrospective analysis was performed on postmenopausal female patients diagnosed with knee osteoarthritis who were hospitalized for knee pain in the Third Orthopedics Department of the First Affiliated Hospital of Guangzhou University of Chinese Medicine from January 2018 to June 2020.The hip-knee-ankle angle of the lower extremity(HKA),medial distal femoral angle(MDFA),medial proximal tibial angle(MPTA),and the angle of the joint line(JLCA)were measured in all patients.The BMD of the lumbar(L1-L4),left femoral neck,and left hip were measured by dual-energy X-ray absorptiometry in all patients.The difference in BMD between the knee varus deformity group and the normal limb alignment group was compared,and the relationship between the different angles of limb alignment and the BMD values at different sites was evaluated.ResultsA total of 202 patients with knee osteoarthritis were included according to the standard of sodium and discharge,all of whom were postmenopausal women,with an average age of 65.5±7.4 years(49-83 years).There were 144 cases in the genu varus group(HKA < 175.3°),including 69 cases of osteoporosis,60 cases of reduced bone mass,and 15 cases of normal bone mass.In the normal force line group(175.3°≤HKA Angle ≤180.3°),there were 58 patients,including 15 patients with osteoporosis,34 patients with reduced bone mass and 9 patients with normal bone mass.The BMD of different parts of the genu varus deformity group was lower than that of the normal group,while the incidence of osteoporosis(47.9%)was higher than that of the normal group(25.9%),with statistical significance(P < 0.05).Binary Logistic regression showed that osteoporosis could significantly affect the occurrence of genu varus deformity.After adjusting for confounding factors such as age,BMI and pain duration,the adjusted OR value was 2.498(95%CI1.215-5.134,P < 0.05).According to Pearson correlation analysis,in all patients,the lumbar spine(L1-L4),femoral neck,hip bone mineral density and HKA Angle were positively correlated(P < 0.05),and negative correlation with JLCA Angle(P < 0.05),the Angle of MPTA and femoral neck,hip BMD values were positively correlated(P < 0.05),and(density value with no correlation(P > 0.05),MDFA horns and the above three parts,bone mineral density values are not correlation(P > 0.05).Finally,in the line of force to normal group,Pearson correlation analysis showed that HKA Angle and negatively correlated with JLCA Angle only(r = 0.481,P < 0.05),no obvious correlation with the MDFAAngle,Angle of MPTA(P < 0.05),while in the knee varus group,Pearson correlation analysis showed that HKA and JLCA Angle exists not only negative correlation(r =0.588,P < 0.05),but also positively correlated with the MDFAAngle,Angle of MPTA(r = 0.383,P < 0.05;R =0.575,P < 0.05).Conclusion1.Knee osteoarthritis and osteoporosis are common in postmenopausal women,which may be related to the common pathogenic factors and pathogenesis of both diseases.2.Osteoporosis should be an important predicting factor for exacerbating knee varus deformity.Maintaining a systemic bone mass level may help to prevent the progression of knee varus deformity in the treatment of KOA.