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 / 대한정형외과학회잡지

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 =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.