Background/Purpose:

There is controversy regarding the relationship between osteoarthritis (OA) and osteoporosis (OP). While OA may be associated with increased bone mineral density (BMD) due to increased weight, evidence exists that the incidence of OP may be increased in patients with OA.

Our purpose was to determine whether the prevalence of OP is increased in patients with OA, compared to age and sex-matched populations.

Methods:

We conducted a systematic literature review using the databases PubMed, Embase, Scopus, and Web of Science, including articles that that analysed the frequency, rate, prevalence, incidence, risk, or excess risk of OP in patients with OA compared to age and sex-matched comparison groups (controls). Articles with fewer than 200 participants, and those without controls were excluded. Two reviewers conducted title and abstract screening.

Results: Of 2772 unique articles, 49 articles were chosen for full article screening, and 6 articles met the inclusion criteria of our present study. These articles showed that there was no significant difference in prevalence of OP in the OA group compared to the respective control group in both men and women, when BMD was measured at femoral neck, hip or lumbar spine (Figure 1). 

Subgroup analysis of both men and women whose BMD was measured at the lumbar spine showed higher prevalence of OP in the control group compared to the OA group (Figure 2). This difference remained significant in the subsequent subgroup analysis of only women whose BMD was measured at the lumbar spine (Figure 3).

Conclusion:

Our findings suggest no significant difference in prevalence of OP in subjects with OA compared to those without OA; this suggests that OA may not have protective effects on development of OP. Therefore, diagnosis of OA should not preclude patients from being investigated for OP. OA may present with atrophic features associated with increased frequency of osteoporotic fractures compared to OA with osteophytosis; this distinction may be important to consider for future studies.

Figure 1. Prevalence of OP in OA vs. control in men and women with BMD measured at any site (lumbar spine, total hip, femoral neck) with confirmed diagnosis of OA at any site (lumbar spine, knee, hand)

Figure 2. Prevalence of OP in OA vs. control in in men and women with BMD measured at the lumbar spine with OA at any site

Figure 3. Prevalence of OP in OA vs. control in women with BMD measured at the lumbar spine with OA at any site

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/the-prevalence-of-osteoporosis-in-individuals-with-osteoarthritis-a-systematic-review/