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Online ISSN 1827-1707
CURRENT TRENDS AND CONTROVERSIES IN HIP DISORDERS - PART II
Department of Orthopedic Surgery,Brigham and Women's Hospital,Harvard Medical School, Boston, MA, USA
Osteoarthritis (OA) and osteoporosis (OP) are two age-related degenerative diseases previously believed to be mutually exclusive. OA is a painful, debilitating disease, while OP may be silent until the subject has a fragility fracture. Several studies of bone mineral density (BMD) with dual-energy X-ray absorptiometry report that between 20% to 29% of women and men with OA have occult OP, which increases their risk of fracture. Furthermore, BMD measurements of the femoral neck of a hip with OA may be elevated due to subchondral osteosclerosis and may not reflect the status of the contralateral hip or the general skeleton. Vitamin D-deficiency is common in patients with OA, with OP, or with both, and should be corrected in order to reduce progression of OA and risk of fracture. Patients with hip OA who appear to be at risk for occult OP are those with advanced age and lower body mass index and with radiographic evidence of thin cortices and osteopenia. Awareness of fracture risk in patients with OA may require paradigm shifts in multidisciplinary care of those patients.