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KMID : 0361620120470050368
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Journal of the Korean Orthopaedic Association
2012 Volume.47 No. 5 p.368 ~ p.374
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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® Criteria
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Lee Su-Chan
Nam Chang-Hyun
Yoon Ji-Yeol
Jung Kwang-Am
Hwang Bo-Hyun
Ahn Hye-Sun
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Abstract
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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®, 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 ≤-2.5 points, or the FRAX® criteria, defined as the 10-year probability of a major osteoporotic fracture and hip fracture of ≥20% 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® 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® criteria.
Conclusion: A combination of the HIRA and FRAX® criteria is required to improve the current guidelines for osteoporosis treatment.
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KEYWORD
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osteoporosis, knee joint, osteoarthritis, HIRA, FRAX®
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