As per a piece of information recently published in the Journal of Orthopaedic Science,  radiographic parameters such as tibiofemoral angle (TFA) and mechanical axis angle (MAA) for femur and tibia can predict BMD distribution around the knee without using dual-energy X-ray absorptiometry. Individuals with severe knee osteoarthritis (OA) present with altered bone mineral density (BMD) of the proximal tibia and distal femur.

Previously, the association between the radiographic parameters show OA progression and medial-to-lateral BMD (M/L-BMD) ratio was not known. This study focused on to evaluate this association within 182 knees of 156 patients with advanced medial knee OA who went through total knee arthroplasty. Various radiographic parameters such as tibial coronal angle, medial and lateral laxity, tibiofemoral angle (TFA), load-bearing axis deviation at the tibial plateau (%), mechanical axis angle (MAA), and tibiofemoral subluxation (%) were evaluated for femoral and tibial M/L-BMD ratios. 

MAA and TFA showed positive association, whereas load-bearing axis deviation and tibial coronal angle showed a negative association with tibial and femoral M/L-BMD ratios. As per findings of multivariate analyses, TFA and MAA showed considerable relationships with femoral M/L-BMD ratio and tibial M/L-BMD ratio, respectively. These outcomes contribute in vivo data on the assessment of preoperative tibial and femoral M/L-BMD ratios without applying dual-energy X-ray absorptiometry.