Table 1 Studies since 2010 examining the association between systemic bone mineral density (BMD) and tibiofemoral cartilage

  Brennan 2011 [16]

N = 160 (100% female)

Asymptomatic participants

Age 29–50 years, mean (SD) 41.4 (5.3) years

BMI 27.6 (6.4) kg/m²

Spine 1.263 (0.150)

Total body 1.178 (0.078)

Femoral neck 1.008 (0.137)

Ward’s triangle 0.915 (0.152)

Trochanter 0.840 (0.112)

Ultra-distal forearm 0.331 (0.043)

Mid forearm 0.712 (0.052)

Spine, total body, and femoral neck BMD were positively associated with medial and lateral cartilage volume. Spine BMD was positively associated with the presence of medial compartment cartilage defects, and forearm BMD was positively associated with the prevalence of lateral compartment cartilage defects

  Berry 2011 [17]

N = 153 (81% female)

Predominantly healthy participants

Age 25–60 years, mean (SD) men 46 (9), women 47 (10) years

BMI, men 30 (8), women 33 (9) kg/m²

Total body, men 1.282 (0.10), women 1.228 (0.10)

Total body BMD was positively associated with medial and lateral tibial cartilage volume in men and women

  Nevitt 2010 [2]

N = 1754 (63.0% female)

Participants with knee OA or at high risk of developing knee OA

Age 50–79 years, mean (SD) 63.2 (7.8) years

BMI 29.9 (5.4) kg/m²

Whole body, men 1.11 (0.11), women 0.94 (0.09)

Femoral neck, men 0.84 (0.13), women 0.77 (0.12)

In knees without knee OA, higher femoral neck and whole body BMD were associated with increases in grade of joint space narrowing. In knees with existing knee OA, progression was not significantly related to BMD

  Lee 2013 [26]

N = 127 (59% female)

Symptomatic knee OA and Kellgren Lawrence grade ≥2

Age >45 years, mean (SD) 62.7 (8.6) years

BMI 30.1 (5.4) kg/m²

2 years follow up

Femoral neck 0.95 (0.14)

There were no significant associations between baseline BMD and cartilage volume or thickness

Longitudinal BMD loss was associated with loss of femoral and tibial cartilage volume and thickness

  Cao 2014 [1]

N = 158 (48% female)

Randomly selected subjects; 69 without radiographic OA and 89 with radiographic OA

Age mean (SD) 62.6 (7.2) years

BMI 27.4 (4.1) kg/m²

2.7 years follow up

Total body 1.08 (0.16)

Total hip 0.98 (0.17)

Spine 1.02 (0.20)

Cross-sectional analysis: total body, total hip, and spine BMD were positively associated with femoral and lateral tibial cartilage thickness in subjects with OA

Longitudinal analysis: high total body BMD was associated with an increase in femoral cartilage thickness; high spine BMD was associated with increases in femoral and lateral tibial cartilage thickness in subjects with OA

No significant associations were observed in subjects without OA