Abstract
This paper aims to (i) identify differences in measures of hip morphology between four racial groups using anteroposterior (AP) hip x-rays, and (ii) examine whether these differences vary by sex. 912 hip x-rays (456 individuals) from four racial groups (European Caucasians, American Caucasians, African Americans and Chinese) were obtained. Males and females (45-75 years) with no radiographic hip OA (Kellgren and Lawrence<Grade 2 or Croft<Grade 1) were included. Eleven features of hip joint morphology were analysed. Linear regression with generalised estimating equations (GEE) was used to determine race and sex differences in hip morphology. Post-hoc Bonferroni procedure was used to adjust for multiple comparisons. The final analysis included 875 hips. Chinese hips showed significant differences for the majority of measures to other racial groups. Chinese were characterised by more shallow and narrow acetabular sockets, reduced femoral head coverage, smaller femoral head diameter, and a lesser angle of alignment between the femoral neck and shaft. Variation was found between other racial groups, but with few statistically significant differences. The average of lateral centre edge angle, minimum neck width and neck length differed between race and sex (p-value for interaction<0.05). Significant differences were found in measures of morphology between Chinese hips compared to African Americans or Caucasian groups; these may explain variation in hip OA prevalence rates between these groups and the lower rate of hip OA in Chinese. Sex differences were also identified, which may further explain male-female prevalence differences for OA.
Highlights
Hip OA is a leading cause of pain and disability globally due to its effects on functional movement and mobility[1]
X-Ray data was acquired from three population-based studies; Chingford (European Caucasians), the Johnston County (JoCo) Osteoarthritis Project (American Caucasians, African Americans), and the Beijing Osteoarthritis Study (Chinese)
Morphometric data was obtained from included x-rays using OxMorf 2.0.0, a validated software program developed by the University of Oxford that assesses 23 hip morphology parameters
Summary
Hip OA is a leading cause of pain and disability globally due to its effects on functional movement and mobility[1]. The disease represents a significant economic burden due to associated healthcare costs and loss of work[2,3]. Around 2.46 million adults in England over 45 have hip OA, which is expected to double by 2020 due to population aging1,3e5. Identifying predisposing risk factors for hip OA will allow preventative interventions to be designed for at-risk individuals[6]. K. Edwards et al / Osteoarthritis and Cartilage 28 (2020) 189e200
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