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in 84 knees and rheumatoid arthritis in 6 knees. The pre-operative mechanical alignment of the lower limbwas in 13.4 6.3 (0-30) varus. The knees were randomized in 1:1:1 ratio into one of the three groups conventional instruments (CON), computer navigation (NAV) and patient specific instruments (PSI). They were also randomized with regard to the 3 surgeons. Each surgeon performed 10 CON, 10 NAV and 10 PSI TKA. The three groups were matched, except there were more male patients in the PSI group. The prostheses and surgical routines were standardized. Post-operative standing long films of the entire lower limbs were taken.We recorded the tourniquet time and the operative time (skin-to-skin). We measured the femoral and tibial component positions in the coronal and axial planes and the overall lower limb alignment of the lower limb after TKA. Results: The mean tourniquet times were 49.2 12.7 minutes for CON, 68.6 14.8 minutes for NAV and 49.1 15.3 minutes for PSI groups (p < 0.001, Oneway ANOVA). Conventional instrument was more likely to result in an excessively flexed femoral component (p 1⁄4 0.001, Oneway ANOVA). Number of outliers in postoperative lower limb alignment, and other components positions in the coronal and sagittal plane showed no statistically significant difference. Conclusion: We found that the tourniquet time and operation time of using patient specific instrument in TKA were similar to that of conventional instrument, and shorten than computer navigation. The postoperative lower limb alignment and individual component positions were similar in all 3 groups except in sagittal plane where conventional instrument resulted in a significantly flexed femoral component. Although statistical significance was not achieved, the incidence of outliers was the highest in the conventional instrument group, followed by patient specific instrument and finally computer navigation. The current studied identifiedmarginal benefit of PSI in isolated component position compared to conventional instrument. A prospective study with a larger sample size and better post-op imaging modality (e.g. CT or MRI) may be needed to prove the efficacy of PSI. 860 MRI-DETECTED OSTEOPHYTE IS A PREDICTOR FOR RECEIVING TOTAL KNEE ARTHROPLASTY IN PATIENTS WITH END-STAGE KNEE OSTEOARTHRITIS L. Liu y,z, H. Kaneko y, R. Sadatsuki y, S. Hada y, A. Yusup y, M. Kinoshita y, I. Futami y, Y. Shimura x, H. Kurosawa x, Y. Saita y, Y. Takazawa y, H. Ikeda y, K. Kaneko y,z, M. Ishijima y,z. yDept. of Med. for Orthopaedics and Motor Organ, Juntendo Univ. Graduate Sch. of Med., Tokyo, Japan; z Sportology Ctr., Juntendo Univ. Graduate Sch. of Med., Tokyo, Japan; xDept. of Orthopaedic Surgery, Juntendo Tokyo Metropolitan Koto Geriatric Med. Ctr., Tokyo, Japan

s / Osteoarthritis and Cartilage 22 (2014) S57–S489 S375 663 BONE TURNOVER MARKERS (BTMS) IN THE SYNOVIAL FLUID IN THE PATIENTS WITH OSTEOARTHRITIS CORRELATES WITH THE SERUM LEVEL OF BTMS THOUGH SOME PATIENTS WITH OSTEOPOROSIS EXHIBIT MISMATCHED INCREASE IN BONE RESORPTION ACTIVITY IN SYNOVIAL FLUID Y. Saita yz, K. Kurata z, T. Sato z, S. Fukasaku z, K. Kaneko y, M. Nemoto z. yDept. of Orthopaedics, Juntendo Univ., Tokyo, Japan; zDept. of Orthopedic Surgery, Kitanarashino Hanawa Hosp., Chiba, Japan Purpose: Little is known regarding the relationships between the osteoarthritis (OA) and osteoporosis especially for the link between the subchondral bone remodeling and pathology of OA. In the patients with severe OA, articular cartilages wear down and subchondral bones become exposed. We hypothesized that BTMs in the synovial fluid would be related to the pathology of OA, and evaluated them in the patients with knee OA. Methods: Twenty seven knees in twenty one postmenopausal women with advanced-stage knee osteoarthritis (Kellgren-Lawrence >2) were analyzed in this study. The average age of patients was 73.4 (range, 52– 83 years). Knee pain was evaluated using visual analogue scales (VAS) and outcome measure for Japanese patients with knee osteoarthritis (JKOM). Tartrate-resistant acidic phosphatase 5b (TRAcP5b) activity and procollagen 1 N-terminal peptide (P1NP) concentrationwere measured both in the serum and synovial fluid. Bone mineral density (BMD) was measured in digital image processing method at second metacarpal bone. In statistics, Spearman’s rank correlation coefficient (r) and statistical significance (p) were calculated using GraphPad Prismversion 6.0 (GraphPad Software). The Mann-Whitney U test was used to compare differences between two independent groups. The values of p 0.5 mm in the index knee) at 3 years was obtained using a Poisson regression model with robust error estimates to obtain relative risk (RR), with adjustment for baseline index JSW, gender, glucosamine use, age, BMI and centre. Each knee was graded according to the Kellgren and Lawrence (KL placebo 0.08 mm/year; 95% CI 0.15–0.30, p 1⁄4 0.51). In the lateral compartment, the equivalent difference between the two groups was 0.07 mm/year (vitamin D 0.11mm/year, placebo 0.18mm/year; 95% CI 0.15–0.30). 39% of patients in the treatment group and 37% of patients in the placebo group showed a clinically significant progression of JSN (>0.5 mm) at 3 years compared to baseline. The unadjusted relative risk of clinically significant progression of JSN for the vitamin D group relative to the placebo group was 1.05 (95% CI 0.77–1.44, p 1⁄4 0.76). The adjusted relative risk was 1.03 (95% CI 0.76–1.40, p 1⁄4 0.83). The odds ratio of a higher KL OVX with alendronate (ALN