J Korean Orthop Assoc.  2012 Oct;47(5):368-374. 10.4055/jkoa.2012.47.5.368.

Comparative Study of Osteoporosis Treatment of Elderly Patients with Degenerative Osteoarthritis of the Knee Joints, according to the Korean Health Insurance Review & Assessment Service Criteria versus the FRAX(R) Criteria

• Lee SC
• Nam CH
• Yoon JY
• Jung KA
• Hwang BH
• Ahn HS

• KMID: 2185321
• DOI: http://doi.org/10.4055/jkoa.2012.47.5.368

Abstract

PURPOSE
To compare and evaluate any differences in the osteoporosis treatments of elderly patients with degenerative osteoarthritis of the knee joints, in accordance with the Korean Health Insurance Review & Assessment Service (HIRA) criteria versus the World Health Organization (WHO) fracture risk assessment tool (FRAX(R), http://www.shef.ac.uk/FRAX/) criteria, which is a fracture risk assessment tool developed by the WHO.
MATERIALS AND METHODS
From June 2010 to March 2011, we investigated and screened the target populations of osteoporosis treatments among 65-year-old or older patients with degenerative osteoarthritis of the knee joints who scheduled to undergo elective total knee arthroplasty. They were classified in the treatment group only if they met either the HIRA criterion, defined as having a T score of < or =-2.5 points, or the FRAX(R) criteria, defined as the 10-year probability of a major osteoporotic fracture and hip fracture of > or =20% or > or =3%, respectively.
RESULTS
Of a total of 929 patients, the number of patients included in the treatment group as screened according to the HIRA or FRAX(R) criteria was 562 (60.5%) and 372 (40.0%), respectively. The number of patients who met both criteria was 339 (36.5%), and including 334 non-treated patients (36.0%), a total of 673 patients (72.4%) showed low diagnostic concordance (k=0.471). Of 319 patients diagnosing osteopenia, 33 (10.3%) patients were included in the treatment group according to the FRAX(R) criteria.
CONCLUSION
A combination of the HIRA and FRAX(R) criteria is required to improve the current guidelines for osteoporosis treatment.

Keyword

osteoporosis; knee joint; osteoarthritis; HIRA; FRAX(R)

MeSH Terms

Aged
Arthroplasty
Bone Diseases, Metabolic
Health Services Needs and Demand
Hip
Humans
Insurance, Health
Knee
Knee Joint
Osteoarthritis
Osteoporosis
Osteoporotic Fractures
Risk Assessment
World Health Organization

Figure

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  Figure 1 WHO fracture risk assessment tool (FRAX®, http://www.shef.ac.uk/FRAX/).

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