• Yun Seong Choi, Jin-Uk Jeong, and Seung Hoon Lee.
• Department of Orthopedic Surgery, Veterans Health Service Medical Center, 53 Jinhwangdo-ro 61-gil, Gangdong-gu, Seoul, 05368, South Korea.
• Arch Orthop Trauma Surg. 2023 Dec 1; 143 (12): 714771517147-7151.

PurposeThe relationship between knee osteoarthritis (OA), bone mineral density (BMD), and alignment has not yet been clarified. This study aimed to investigate the relationship between the two limbs in patients with single-limb knee OA.MethodsPatients who underwent single-limb total knee arthroplasty between March 2019 and February 2021 were retrospectively analyzed. Only patients with Kellgren-Lawrence (KL) grades III and IV on the operated side and KL I and II on the opposite side were included. Patients with traumatic OA, a surgery that could change the alignment of both lower extremities and previous fractures were excluded. The proximal femur BMD on the OA and non-OA sides were compared. In addition, the difference in BMD was compared between a group with a difference in alignment of both lower extremities (> 5°) and a group without a difference (< 5°).ResultsIn total, 149 patients were included. The BMD T-score of the femoral neck on the OA side was lower than that of the non-OA side (p < 0.001). There was no correlation between BMD and alignment, and there was no difference in BMD according to the difference in alignment.ConclusionThe femoral neck BMD of the leg on the side with knee OA was lower than that on the side without OA. However, the alignment difference between the legs did not affect BMD. BMD was lowered because of OA and not because of alignment.© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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