Session Type: ACR Poster Session A
Session Time: 9:00AM-11:00AM
Background/Purpose: Osteonecrosis of the femoral head (ONFH) is characterized by epiphyseal necrosis that can lead to sub-chondral fracture, femoral head collapse and hip replacement. Osteoporosis (OP) and ONFH share common clinical and pathophysiological features such the occurrence of fracture, risks factors (GC and alcohol) and altered bone cells functions. This study was undertaken to study BMD in patients with pre-fractural (stage 1 and 2) and fractural stages (stage 3 and 4) of ONFH and to determine whether ONFH at a fractural stage was associated with an increased prevalence of OP
Methods: We included 243 patients with ONFH and 399 age and sex-matched healthy controls in this prospective controlled trial. Data was gathered including demography, risk factors, ARCO staging of ONFH and bone mineral density (BMD). Patients were stratified according to the staging (pre-fractural and fractural stages) of ONFH at diagnosis and BMD.
Results: BMD (defined by the T-score) was significantly lower in the ONFH group at both the femoral head (-0.96 ± 1.11) and the lumbar spine (-1.22 ± 1.47) compared to the control group (-0.55 ± 0.97 and -0.73 ± 1.31) (p<0.01). The ONFH group depicted a significantly higher proportion of osteopenia (50.39% vs 40.87%, p =0.027) and of OP (18.78% vs 7.33%, p <0.001) relative to the control group. Furthermore, we analyzed BMD of ONFH patients according to the stage of ONFH at diagnosis. We observed that stage 1-2 ONFH patients (53.86%) (but not stages 3-4) were at a higher risk of osteopenia than the control group (40.88%, p =0.0203) with an odds ratio of 1.27 (95% CI: [0.78; 2.06]). Moreover, stage 3 and 4 ONFH patients (25.31%) were at a higher risk of osteoporosis (with an odds ratio of 4.89 (95% CI: [2.77; 8.76]) than patients in the stage 1 and 2 group (7.24%, p <0.001) and compared to the control group (with an odds ratio of 4.89 7.33%, p <0.001).
Conclusion: Fractural stages ONFH were associated with a 5-fold risk of osteoporosis. Therefore, we advise that patients suffering of ONFH should be screened for low bone mass.
To cite this abstract in AMA style:soyfoo M, Gangji V, moreno R, Rasschaert J, Hauzeur JP. Osteonecrosis of the Femoral Head Is Associated with Low Bone Mass. [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/osteonecrosis-of-the-femoral-head-is-associated-with-low-bone-mass/. Accessed July 23, 2019.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/osteonecrosis-of-the-femoral-head-is-associated-with-low-bone-mass/