Hoaglund F T, Steinbach L S
Department of Orthopaedic Surgery, University of California at San Francisco Medical Center, 500 Parnassus Avenue (MU 320-W), San Francisco, CA 94143-0728, USA.
J Am Acad Orthop Surg. 2001 Sep-Oct;9(5):320-7. doi: 10.5435/00124635-200109000-00005.
Primary osteoarthritis (OA) of the hip has a distinct etiology and epidemiology compared with other types of arthropathy in the hip joint. Arthritis of the hip can be secondary to conditions such as osteonecrosis, trauma, sepsis, or rheumatoid arthritis. Certain conditions, such as congenital hip disease and slipped capital femoral epiphysis, involve predisposing anatomic abnormalities; in such cases, the term "secondary OA" is used. When either an anatomic abnormality cannot be determined or other specific causative entities are not identified, primary OA is the diagnosis of exclusion. The prevalence of hip OA is about 3% to 6% in the Caucasian population and has not changed in the past four decades. In contrast, studies in Asian, black, and East Indian populations indicate a very low prevalence of hip OA. Statistics on patients who underwent total hip replacement for primary OA in San Francisco and Hawaii demonstrate a virtual absence of the condition in Asians and low rates in the black and Hispanic populations. Family studies from Sweden, Britain, and the United States show increased rates of hip OA in first-degree relatives of the index patient when compared with the normal population. Occupations requiring heavy lifting, farming, and elite sports activity are associated with increased rates of hip OA. The low prevalence of hip OA in Asian and black populations in their native countries; the low incidence of total joint replacement for primary OA in Asian, black, and Hispanic populations in North America; and the familial association of hip OA in Caucasians all suggest that genetic factors may be involved in the occurrence of this disease.
与髋关节其他类型的关节病相比，原发性髋骨关节炎（OA）具有独特的病因和流行病学特征。髋关节关节炎可能继发于骨坏死、创伤、败血症或类风湿性关节炎等病症。某些情况，如先天性髋关节疾病和股骨头骨骺滑脱，涉及易患解剖学异常；在这种情况下，使用“继发性OA”一词。当无法确定解剖学异常或未识别其他特定致病因素时，原发性OA是排除性诊断。在白种人群中，髋OA的患病率约为3%至6%，在过去四十年中没有变化。相比之下，对亚洲、黑人和东印度人群的研究表明，髋OA的患病率非常低。旧金山和夏威夷接受原发性OA全髋关节置换术患者的统计数据显示，亚洲人几乎没有这种疾病，黑人和西班牙裔人群的发病率较低。瑞典、英国和美国的家族研究表明，与正常人群相比，索引患者的一级亲属中髋OA的发病率增加。需要重物搬运、务农和精英体育活动的职业与髋OA发病率增加有关。亚洲和黑人在其本国髋OA患病率较低；北美亚洲、黑人和西班牙裔人群原发性OA全关节置换术的低发病率；以及白种人中髋OA的家族关联，都表明遗传因素可能与这种疾病的发生有关。
