TY - JOUR
T1 - Predictors of total hip replacement in community based older adults
T2 - a cohort study
AU - Laslett, Laura
AU - Ahedi, Harbeer G.
AU - Leigh Blizzard, Christopher
AU - Aspden, Richard
AU - Gregory, Jenny
AU - Saunders, Fiona
AU - Mezhov, Veronica
AU - Munugoda, Ishanka
AU - Cai, Guoqi
AU - Cicuttini, Flavia M.
AU - Graves, Stephen
AU - Lorimer, Michelle
AU - Jones, Graeme
N1 - This work was supported by the National Health and Medical Research Council of Australia (NHMRC Grant ID – 302204); Tasmanian Community Fund (Grant ID – D0015018); Masonic Centenary Medical Research Foundation; Royal Hobart Hospital Research Foundation; Arthritis Foundation of Australia (Grant ID – MRI06161); and University of Tasmania institutional research grants scheme (D0015019). The study sponsor had no role in the design of the study; the collection, analysis, and interpretation of the data; or the writing of the article and the decision to submit it for publication. Laura Laslett is supported by a National Health and Medical Research Council of Australia Early Career Fellowship (1070586). Graeme Jones is supported by a NHMRC Practitioner Fellowship (1023222).
PY - 2021/8
Y1 - 2021/8
N2 - The purpose of this study is to describe predictors of total hip replacement (THR) in community dwelling older adults. A better understanding of predictors of THR can aid in triaging patients and researching preventative strategies. At baseline, participants had assessment of radiographic OA and cam morphology (from pelvic radiographs), shape mode scores and hip bone mineral density (BMD; from dual energy X-ray absorptiometry (DXA)). After 2.6 and 5 years, participants reported hip pain using WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index), and had hip structural changes assessed using magnetic resonance imaging (MRI). Risk of THR was analysed using mixed-effect Poisson regression. Incidence of THR for OA over 14 years was 4.6% (37/801). As expected, WOMAC hip pain and hip radiographic OA both predicted risk of THR. Additionally, shape mode 2 score (decreasing acetabular coverage) (RR 1.83 per SD; 95% CI 1.1-3.04), shape mode 4 score (non-spherical femoral head) (RR 0.59/SD; 95% CI 0.36-0.96), cam morphology (α >60°) (RR 2.2/SD; 95% CI 1.33-3.36), neck of femur BMD (RR 2.09/SD, 95% CI 1.48-2.94) and bone marrow lesions (BMLs) increased risk of THR (RR 7.10/unit; 95% CI 1.09-46.29). In addition to hip pain and radiographic hip OA, measures of hip shape, cam morphology, BMD and BMLs independently predict risk of THR. This supports the role of hip bone geometry and structure in the pathogenesis of end stage hip OA and has identified factors that can be used to improve prediction models for THR. [Abstract copyright: Copyright © 2021. Published by Elsevier Ltd.]
AB - The purpose of this study is to describe predictors of total hip replacement (THR) in community dwelling older adults. A better understanding of predictors of THR can aid in triaging patients and researching preventative strategies. At baseline, participants had assessment of radiographic OA and cam morphology (from pelvic radiographs), shape mode scores and hip bone mineral density (BMD; from dual energy X-ray absorptiometry (DXA)). After 2.6 and 5 years, participants reported hip pain using WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index), and had hip structural changes assessed using magnetic resonance imaging (MRI). Risk of THR was analysed using mixed-effect Poisson regression. Incidence of THR for OA over 14 years was 4.6% (37/801). As expected, WOMAC hip pain and hip radiographic OA both predicted risk of THR. Additionally, shape mode 2 score (decreasing acetabular coverage) (RR 1.83 per SD; 95% CI 1.1-3.04), shape mode 4 score (non-spherical femoral head) (RR 0.59/SD; 95% CI 0.36-0.96), cam morphology (α >60°) (RR 2.2/SD; 95% CI 1.33-3.36), neck of femur BMD (RR 2.09/SD, 95% CI 1.48-2.94) and bone marrow lesions (BMLs) increased risk of THR (RR 7.10/unit; 95% CI 1.09-46.29). In addition to hip pain and radiographic hip OA, measures of hip shape, cam morphology, BMD and BMLs independently predict risk of THR. This supports the role of hip bone geometry and structure in the pathogenesis of end stage hip OA and has identified factors that can be used to improve prediction models for THR. [Abstract copyright: Copyright © 2021. Published by Elsevier Ltd.]
KW - Hip osteoarthritis
KW - Total hip replacement
KW - Bone shape
KW - Bone mineral density
KW - Cam morphology
KW - Bone marrow lesions
KW - Predictors
U2 - 10.1016/j.joca.2021.04.013
DO - 10.1016/j.joca.2021.04.013
M3 - Article
C2 - 33965528
VL - 29
SP - 1130
EP - 1137
JO - Osteoarthritis and Cartilage
JF - Osteoarthritis and Cartilage
SN - 1063-4584
IS - 8
ER -