284 HIP FLEXION, SOCIAL FUNCTIONING, AND SELF-EFFICACY FOR PAIN PREDICT PHYSICAL FUNCTION AT 16 MONTHS IN PATIENTS WITH HIP OSTEOARTHRITIS

Abstract

Purpose: We have recently described increased atherosclerosis in elderly females vith hand OA. This study examines the relationship between knee (TKR) and hip (THR) joint replacements (TJR) due to OA and atherosclerotic vascular disease in the same population. Methods: In this population-based multidisciplinary study of aging in the elderly population of Reykjavik, Iceland, TJR’s were recorded from CT scans and hand osteoarthritis (HOA) from hand photographs as previously described (1). After excluding those with inflammatory arthritis and fractures as the reason for TJR we had information about TKR and THR presumably due to OA, and HOA in 2195 males and 2975 females, mean age 76±6 years. The prevalence of TKR was 223 (4.3%) and THR 316 (6.1%). The OA data were analysed in relation to measures of atherosclerosis. These included carotid intimal thickness and plaque severity (ultrasound), coronary and aortic calcifications (CT), cerebral white matter lesions (MRI) and history of previous cardiac and cerebral events. All measurements were adjusted for age, BMI, hs-CRP, cholesterol, triglycerides, smoking history, statin use and pulse pressure. Results: The presence of TJR’s in females was associated with a nonsignificant trend towards increased carotid plaque severity, coronary calcifications and periventricular white matter hyperintensities but not with history of cardiac or cerebral events. No associations were seen in males. When TJR’s were coupled with the presence or absence of HOA there was a highly significant association in the order -TJR/-HOA < +TJR/-HOA < -TJR/+HOA < +TJR/+HOA, for carotid plaque severity, coronary calcifications and periventricular white matter hyperintensities. As an example, the adjusted coronary calcification measure (Agatston units (log)) was 4.14±0.16 in females with neither TJR nor HOA and 4.66±0.14 in females with both TJR and HOA. Conclusions: The presence of TJR’s did not have a significant independent association with atherosclerosis but increased the strength of the positive association between HOA and atherosclerosis in females. Thus, females with both TJR and HOA have an approximately 10% increase in a number of atherosclerosis measurements compared with those without evidence of OA. These findings are in agreement with our previous findings indicating an overlap between the pathological processes of OA and atherosclerosis. They also indicate the existence of a generalized systemic form of osteoarthritis that needs to be defined further.