Predictors of total hip replacement in community based older adults: a cohort study

Laura  Laslett; Harbeer G.  Ahedi; Christopher  Leigh Blizzard; Richard  Aspden; Jenny Gregory; Fiona Saunders; Veronica  Mezhov; Ishanka  Munugoda; Guoqi  Cai; Flavia M.  Cicuttini; Stephen  Graves; Michelle  Lorimer; Graeme Jones

doi:10.1016/j.joca.2021.04.013

Predictors of total hip replacement in community based older adults: a cohort study

Laura Laslett^* (Corresponding Author), Harbeer G. Ahedi, Christopher Leigh Blizzard, Richard Aspden, Jenny Gregory, Fiona Saunders, Veronica Mezhov^* (Corresponding Author), Ishanka Munugoda, Guoqi Cai, Flavia M. Cicuttini, Stephen Graves, Michelle Lorimer, Graeme Jones

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

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Abstract

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.]

Original language	English
Pages (from-to)	1130-1137
Number of pages	8
Journal	Osteoarthritis and Cartilage
Volume	29
Issue number	8
Early online date	7 May 2021
DOIs	https://doi.org/10.1016/j.joca.2021.04.013
Publication status	Published - Aug 2021

Bibliographical note

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).

Keywords

Hip osteoarthritis
Total hip replacement
Bone shape
Bone mineral density
Cam morphology
Bone marrow lesions
Predictors

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10.1016/j.joca.2021.04.013

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© 2021. This manuscript version is made available under the CC-BY-NC-ND 4.0 license https://creativecommons.org/licenses/by-nc-nd/4.0/
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Cite this

@article{cde1def8d66346308972e2b85dc55763,

title = "Predictors of total hip replacement in community based older adults: a cohort study",

abstract = "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 {\textcopyright} 2021. Published by Elsevier Ltd.]",

keywords = "Hip osteoarthritis, Total hip replacement, Bone shape, Bone mineral density, Cam morphology, Bone marrow lesions, Predictors",

author = "Laura Laslett and Ahedi, {Harbeer G.} and {Leigh Blizzard}, Christopher and Richard Aspden and Jenny Gregory and Fiona Saunders and Veronica Mezhov and Ishanka Munugoda and Guoqi Cai and Cicuttini, {Flavia M.} and Stephen Graves and Michelle Lorimer and Graeme Jones",

note = "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).",

year = "2021",

month = aug,

doi = "10.1016/j.joca.2021.04.013",

language = "English",

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pages = "1130--1137",

journal = "Osteoarthritis and Cartilage",

issn = "1063-4584",

publisher = "ELSEVIER APPL SCI PUBL LTD",

number = "8",

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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

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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

SN - 1063-4584

VL - 29

SP - 1130

EP - 1137

JO - Osteoarthritis and Cartilage

JF - Osteoarthritis and Cartilage

IS - 8

ER -

Predictors of total hip replacement in community based older adults: a cohort study

Abstract

Bibliographical note

Keywords

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