Fragility Fractures in Patients with Rheumatoid Arthritis and Osteoarthritis Compared with the General Population

Yuri Yamamoto; Aleksandra Turkiewicz; Hans Wingstrand; Martin Englund

doi:10.3899/jrheum.150325

Fragility Fractures in Patients with Rheumatoid Arthritis and Osteoarthritis Compared with the General Population

J Rheumatol. 2015 Nov;42(11):2055-8. doi: 10.3899/jrheum.150325. Epub 2015 Oct 1.

Authors

Yuri Yamamoto¹, Aleksandra Turkiewicz¹, Hans Wingstrand¹, Martin Englund²

Affiliations

¹ From the Department of Rehabilitation, Nagoya University Hospital, Nagoya, Japan; Orthopedics, Department of Clinical Sciences, Lund University; Epidemiology and Register Centre South, Skåne University Hospital, Region Skåne, Lund, Sweden; Clinical Epidemiology Research and Training Unit, Boston University School of Medicine, Boston, Massachusetts, USA.Y. Yamamoto, PT, Department of Rehabilitation, Nagoya University Hospital; A. Turkiewicz, MSc, Orthopedics, Department of Clinical Sciences, Lund University; H. Wingstrand, MD, PhD, Orthopedics, Department of Clinical Sciences, Lund University; M. Englund, MD, PhD, Orthopedics, Department of Clinical Sciences, Lund University, and Epidemiology and Register Centre South, Skåne University Hospital, and Clinical Epidemiology Research and Training Unit, Boston University School of Medicine.
² From the Department of Rehabilitation, Nagoya University Hospital, Nagoya, Japan; Orthopedics, Department of Clinical Sciences, Lund University; Epidemiology and Register Centre South, Skåne University Hospital, Region Skåne, Lund, Sweden; Clinical Epidemiology Research and Training Unit, Boston University School of Medicine, Boston, Massachusetts, USA.Y. Yamamoto, PT, Department of Rehabilitation, Nagoya University Hospital; A. Turkiewicz, MSc, Orthopedics, Department of Clinical Sciences, Lund University; H. Wingstrand, MD, PhD, Orthopedics, Department of Clinical Sciences, Lund University; M. Englund, MD, PhD, Orthopedics, Department of Clinical Sciences, Lund University, and Epidemiology and Register Centre South, Skåne University Hospital, and Clinical Epidemiology Research and Training Unit, Boston University School of Medicine. martin.englund@med.lu.se.

PMID: 26428208
DOI: 10.3899/jrheum.150325

Abstract

Objective: To determine the rate ratios of hip and distal radius fractures in patients with rheumatoid arthritis (RA), hip osteoarthritis (OA), and knee OA.

Methods: Cohort study using healthcare data (1998-2012) covering the entire population of the Skåne region of Sweden.

Results: We found an increased rate of hip fracture in both female [standardized fracture rate ratio (SFR) 1.54, 95% CI 1.40-1.70] and male patients with RA (SFR 1.81, 95% CI 1.51-2.17). The hip fracture rate in female OA was reduced by 10-20%, and trochanteric fracture tended to have a higher rate ratio compared with the cervical.

Conclusion: The 50-80% increased rate of hip fracture adds to the total burden of RA while the shifted distribution of cervical/trochanteric fractures in OA is in support of subchondral bone alterations.

Keywords: EPIDEMIOLOGY; FRACTURES; OSTEOARTHRITIS; OSTEOPOROSIS; RHEUMATOID ARTHRITIS.

Publication types

Comparative Study
Research Support, Non-U.S. Gov't

MeSH terms

Age Factors
Aged
Antirheumatic Agents / therapeutic use
Arthritis, Rheumatoid / complications*
Arthritis, Rheumatoid / diagnosis
Arthritis, Rheumatoid / drug therapy
Case-Control Studies
Female
Fractures, Spontaneous / diagnostic imaging
Fractures, Spontaneous / epidemiology
Fractures, Spontaneous / etiology*
Hip Fractures / diagnostic imaging
Hip Fractures / epidemiology*
Hip Fractures / etiology*
Humans
Incidence
Male
Middle Aged
Osteoarthritis / complications*
Osteoarthritis / diagnosis
Osteoarthritis / drug therapy
Osteoarthritis, Hip / complications
Osteoarthritis, Hip / diagnosis
Osteoarthritis, Hip / drug therapy
Osteoarthritis, Knee / complications
Osteoarthritis, Knee / diagnosis
Osteoarthritis, Knee / drug therapy
Predictive Value of Tests
Prognosis
Radiography
Radius Fractures / diagnostic imaging
Radius Fractures / epidemiology
Radius Fractures / etiology*
Reference Values
Registries
Retrospective Studies
Risk Assessment
Severity of Illness Index
Sex Factors
Sweden / epidemiology

Substances

Antirheumatic Agents