Abstract
BackgroundTo identify baseline radiographic features that predict hip osteoarthritis (HOA) progression, and to explore differences in these associations by race.MethodsRadiographs from the community-based Johnston County OA Project were scored using Kellgren-Lawrence (KL) grade and for presence and location of joint space narrowing (JSN), osteophytes, and subchondral changes. Associations between these features and HOA progression (increase of at least 1 KL grade, interval hip replacement, range of motion [ROM, a reduction of ≥10° in internal rotation], or disability [increase of ≥0.2 in Health Assessment Questionnaire scores], or Any of these) were assessed using logistic regression, adjusting for age, gender, race, hip injury, BMI, education, smoking and follow-up time, accounting for multiple comparisons. Race interactions were assessed and analyses stratified as indicated.ResultsThe sample (n = 1,422) included 40 % men and 26 % African American (AA) participants, with mean age 61 years and BMI 29 kg/m2. The baseline frequency of radiographic hip OA (RHOA) between Caucasians and AAs was similar (23 %), although some radiographic features differed. AAs were more likely to have progression defined by ROM or disability or Any progression; Caucasians were more likely to have RHOA progression. JSN, subchondral sclerosis, and medial osteophytes were associated with increased RHOA progression overall; JSN was associated with disability progression only in AAs, while lateral osteophytes were associated with ROM progression only in Caucasians.ConclusionsAAs and Caucasians exhibited differences in the radiographic presentation and progression patterns of HOA, with AAs reporting progressive pain and disability, while Caucasians had more RHOA progression.
Highlights
To identify baseline radiographic features that predict hip osteoarthritis (HOA) progression, and to explore differences in these associations by race
Hip OA (HOA) in particular is associated with limitations in walking and climbing stairs and is the most common indication for total hip replacement surgery (THR) [5, 6]
Eight percent of participants met the criteria for at least mild depression, defined as a Center for Epidemiologic Studies Depression Scale (CES-D) score >16 [33]
Summary
To identify baseline radiographic features that predict hip osteoarthritis (HOA) progression, and to explore differences in these associations by race. Osteoarthritis (OA) is a common, chronic condition that affects 11 % of the general adult population, and is the most common form of arthritis [1]. This percentage is expected to rise to 25 % by 2030, with 9.3 % of the population reporting activity limitation due to some type of arthritis [2]. Hip OA (HOA) in particular is associated with limitations in walking and climbing stairs and is the most common indication for total hip replacement surgery (THR) [5, 6]. Progression in HOA has been measured in a variety of ways in previous studies, including (individually or in combination): 1. Decrease in radiographic joint space (either quantitative or qualitative) [8,9,10,11,12,13,14,15,16,17,18,19]
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