| Part 1 Distribution characteristics and correlation of bone mass in different parts of postmenopausal women with knee osteoarthritisObjectives To investigate the distribution and correlation of bone mineral density(BMD)in lumbar spine,femoral neck and knee joint of patients with knee osteoarthritis.Methods A total of 150 patients with primary knee osteoarthritis from December 2018 to December 2020 were selected to measure the BMD of lumbar spine,femoral neck and ipsilateral knee joint.Then the knee joint was divided into six regions of interest(ROI),which were marked as R1～R6,with R1 representing the medial side of proximal tibia,R2 representing the lateral side of proximal tibia,R3 representing proximal tibia,R4 representing the medial side of distal femur,R5 representing the lateral side of distal femur and R6 representing the distal femur.According to K-L classification,the patients were divided into grade 0 group(33 cases),grade Ⅰ-Ⅱgroup(61 cases)and grade Ⅲgroup(56 cases).The BMD of each ROI was compared,and then the BMD of each ROI was compared in pairs,and the correlation between the BMD of each ROI and the BMD of lumbar spine and femoral neck was analyzed.Results A total of 150 patients with primary knee osteoarthritis were included.Among them,there were 83 patients with osteoporosis,accounting for 55.3%;there were 51 patients with bone loss,accounting for 34.0%;there were 16 patients with normal bone mass,accounting for 10.7%.There are significant differences in BMD of femoral neck,R2,R3,R4,R5 and R6 among the three groups(P<0.05).The BMD of R2,R4,R5 and R6 in grade group was lower than that in grade 0 gⅢ roup.BMD of femoral neck,R2 and R3 in grade Ⅲgroup was lower than that in grade Ⅰ-Ⅱgroup,and the difference was statistically significant(P<0.05).BMD of each ROI of knee joint in three groups was R5>R6>R4>R1,R2 and R3.There was a significant difference between R1 and R2 in grade 0 group(P<0.05).There was no significant difference between R1,R2 and R3 in gradeⅠ-Ⅱgroup and grade Ⅲgroup(P>0.05).R1 compared with R4,R5 and R6,R2 compared with R4,R5 and R6,R3 compared with R4,R5 and R6,R4 compared with R5 and R6,R5 compared with R6 in three groups,the difference was statistically significant(P<0.05).In grade 0 patients,the BMD of R2,R5 and R6 was positively correlated with the BMD of lumbar spine and femoral neck(P<0.05),while the BMD of R1 and R3 was only positively correlated with the BMD of lumbar spine(P<0.05).In grade Ⅰ-Ⅱ group patients,the BMD of each ROI was positively correlated with the BMD of lumbar spine and femoral neck(P<0.05).In grade Ⅲgroup patients,the BMD of R1 and R3 were positively correlated with the BMD of lumbar spine and femoral neck(P<0.05),while the BMD of R2,R4,R5 and R6 were only positively correlated with the BMD of femoral neck(P<0.05).Part 2 Clinical effect of alendronate on bone mass distribution in different parts of postmenopausal women with osteoporosis and knee osteoarthritisObjectives To investigate the effect of alendronate on bone mass distribution in different parts of postmenopausal women with osteoporosis and knee osteoarthritis.Methods A total of 105 postmenopausal women treated from December 2015 to December 2019 were divided into osteoporosis with knee osteoarthritis group(OP+OA group,53 cases)and osteoporosis group(OP group,52 cases).Both groups were treated with alendronate sodium 70 mg once a week for more than 12 months.The bone mineral density(BMD)of lumbar spine,femoral neck and knee joint,Lequesne score,WOMAC score and biochemical indexes were compared between the two groups before and after treatment.The knee joint was divided into six regions of interest(ROI),which were marked as R1～R6,with R1 representing the medial side of proximal tibia,R2 representing the lateral side of proximal tibia,R3 representing proximal tibia,R4 representing the medial side of distal femur,R5 representing the lateral side of distal femur and R6 representing the distal femur.Results The BMD of each ROI in the knee joint of OP group was positively correlated with the BMD of lumbar spine and ipsilateral femoral neck(P<0.05),while that of OP+OA group was positively correlated with the BMD of ipsilateral femoral neck(P<0.05).6months after treatment,the BMD of lumbar spine,femoral neck,R1,R2,R3 in two groups and R6 in OP group were higher than those before treatment,and the difference was statistically significant(P<0.05).12 months after treatment,BMD of lumbar spine,femoral neck,R1,R2,R3 and R6 in two groups,BMD of R5 in OP group and BMD of R4 in OP+OA group were higher than those before treatment and 6 months after treatment,and the difference was statistically significant(P<0.05).12 months after treatment,the BMD of R4 in OP+OA group was higher than that in OP group(P<0.05).In OP+OA group,the knee joint Lequesne score at 6 months after treatment was lower than that before treatment,and the Lequesne score at 12 months after treatment was lower than that before treatment and 6 months after treatment,with significant difference(P<0.05).WOMAC scores of patients in OP+OA group at 12 months after treatment were significantly lower than those before and 6 months after treatment(P<0.05).Conclusions 1 With the development of KOA,BMD of femoral neck and local BMD of knee joint except proximal tibia decreased.2 There are differences in BMD in different ROI of knee joint,and BMD in proximal tibia is lower than that in distal femur;BMD in different areas of knee joint is correlated with BMD of lumbar vertebrae and ipsilateral femoral neck.3 Alendronate sodium can not only improve the BMD of lumbar spine and hips of postmenopausal women with OP and KOA,but also improve the BMD of some local areas of knee joint.4 Alendronate sodium can improve joint symptoms of KOA patients.Figure 8;Table 11;Reference 68... |
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