University Hospital, Akureyri, Iceland.
Arthritis Care Res (Hoboken). 2011 May;63(5):689-95. doi: 10.1002/acr.20412.
To evaluate the association between radiographic hip osteoarthritis (OA) and future total hip replacement (THR) due to OA or hip fracture.
We studied a cohort of individuals who had colon radiography from 1980-1997. Minimal joint space (MJS) was measured and each hip was graded for radiographic OA according to the Kellgren/Lawrence scale. Subjects were followed until the end of 2008. A Cox proportional hazards model, adjusted for age and sex, was used to evaluate factors associated with THR and hip fracture.
A total of 2,953 hips were studied (57% women). The cumulative incidence of THR was 2.5% and the cumulative incidence of hip fracture was 2.6%. For hips with radiographic hip OA (MJS of 2.5 mm or less), the cumulative incidence of THR was 16.9% and the hazard ratio (HR) for THR was 13.2 (95% confidence interval [95% CI] 8.1-21). Using Kellgren/Lawrence grading, the HR for THR was 12.9 (95% CI 7.9-21) for hips with radiographic OA compared to those without. The HR for all types of hip fracture for hips with radiographic OA (MJS of 2.5 mm or less) was 0.47 (95% CI 0.15-1.5), for intracapsular fractures was 0.29 (95% CI 0.04-2.1), and for extracapsular fractures was 0.67 (95% CI 0.16-2.8).
The risk of THR due to OA is substantially increased in patients with radiographic hip OA, regardless of symptoms, and increases with decreasing MJS. However, 11-28 years after having had radiographic hip OA, more than 4 of 5 of those having radiographic signs of hip OA had not had a THR for OA.
评估影像学髋关节骨关节炎（OA）与因 OA 或髋部骨折而进行的未来全髋关节置换术（THR）之间的关联。
我们研究了一组在 1980-1997 年接受过结肠 X 光检查的个体。测量最小关节间隙（MJS），并根据 Kellgren/Lawrence 量表对每个髋关节进行影像学 OA 分级。受试者随访至 2008 年底。使用 Cox 比例风险模型，调整年龄和性别，评估与 THR 和髋部骨折相关的因素。
共研究了 2953 个髋关节（57%为女性）。THR 的累积发生率为 2.5%，髋部骨折的累积发生率为 2.6%。对于有影像学髋关节 OA（MJS 为 2.5 毫米或以下）的髋关节，THR 的累积发生率为 16.9%，THR 的风险比（HR）为 13.2（95%置信区间[95%CI]为 8.1-21）。使用 Kellgren/Lawrence 分级，与无影像学 OA 的髋关节相比，影像学 OA 髋关节的 THR HR 为 12.9（95%CI 为 7.9-21）。对于有影像学 OA（MJS 为 2.5 毫米或以下）的髋关节，所有类型髋部骨折的 HR 为 0.47（95%CI 为 0.15-1.5），对于囊内骨折为 0.29（95%CI 为 0.04-2.1），对于囊外骨折为 0.67（95%CI 为 0.16-2.8）。
无论有无症状，影像学髋关节 OA 患者的 OA 所致 THR 风险均显著增加，且随着 MJS 的降低而增加。然而，在有影像学髋关节 OA 11-28 年后，超过 5 例中有 4 例有影像学髋关节 OA 迹象的患者尚未进行 OA 所致 THR。
