Nelson A E, Stiller J L, Shi X A, Leyland K M, Renner J B, Schwartz T A, Arden N K, Jordan J M
Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Osteoarthritis Cartilage. 2016 Mar;24(3):443-50. doi: 10.1016/j.joca.2015.10.007. Epub 2015 Oct 20.
We sought to describe the effect of alterations in hip morphology with respect to worsening hip OA in a community-based sample including African American (AA) and white men and women.
This nested case-control study defined case hips as Kellgren Lawrence grade (KLG) <3 on baseline supine pelvis radiographs and KLG ≥3 or THR for OA at the 1st or 2nd follow-up visit (mean 6 and 13 years, respectively); control hips had KLG <3 at both visits, with gender/race distribution similar to cases. Hip morphology was assessed using HipMorf software (Oxford, UK). Descriptive means and standard errors were obtained from generalized estimating equation (GEE) models. Sex-stratified GEE regression models (accounting for within-person correlation), adjusted for age, race, BMI, and side were then employed.
A total of 120 individuals (239 hips; 71 case/168 control) were included (25% male, 26% AA, mean age 62 years, BMI 30 kg/m(2)). Case hips tended to have greater baseline AP alpha angles, smaller minimum joint space width (mJSW) and more frequent triangular index signs. Adjusted results among men revealed that higher AP alpha angle, Gosvig ratio, and acetabular index were positively associated with case hips; coxa profunda was negatively associated. Among women, greater AP alpha angle, smaller mJSW, protrusio acetabuli, and triangular index sign were associated with case hips.
We confirmed an increased risk of worsening hip OA due to baseline features of cam deformity among men and women, as well as protrusio acetabuli among women, and provide the first estimates of these measures in AAs.
我们试图在一个包括非裔美国（AA）和白人男性及女性的社区样本中，描述髋关节形态改变对髋关节骨关节炎（OA）病情恶化的影响。
这项巢式病例对照研究将病例髋关节定义为：在基线仰卧位骨盆X线片上Kellgren Lawrence分级（KLG）<3，且在第1次或第2次随访时（分别平均为6年和13年）因OA导致KLG≥3或进行全髋关节置换术（THR）；对照髋关节在两次随访时KLG均<3，其性别/种族分布与病例相似。使用HipMorf软件（英国牛津）评估髋关节形态。从广义估计方程（GEE）模型中获得描述性均值和标准误。然后采用按性别分层的GEE回归模型（考虑个体内相关性），并对年龄、种族、体重指数（BMI）和患侧进行校正。
共纳入120名个体（239个髋关节；71例/168例对照）（25%为男性，26%为非裔美国人，平均年龄62岁，BMI为30kg/m²）。病例髋关节往往具有更大的基线前后位（AP）α角、更小的最小关节间隙宽度（mJSW）以及更频繁的三角形指数征。男性的校正结果显示，较高的APα角、Gosvig比率和髋臼指数与病例髋关节呈正相关；髋臼深与病例髋关节呈负相关。在女性中，较大的APα角、较小的mJSW、髋臼前突和三角形指数征与病例髋关节相关。
我们证实，男性和女性因凸轮畸形的基线特征以及女性的髋臼前突，导致髋关节OA病情恶化的风险增加，并首次在非裔美国人中对这些指标进行了评估。
