Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan; Laboratory for Statistical and Translational Genetics Analysis, RIKEN Center for Integrative Medical Sciences, Yokohama City, Kanagawa, Japan.
Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan.
J Arthroplasty. 2024 Feb;39(2):393-397.e1. doi: 10.1016/j.arth.2023.08.026. Epub 2023 Aug 14.
Developmental dysplasia of the hip (DDH) is considered to have genetic predisposition and presents many intrafamilial occurrences. However, there is no report that evaluates the effect of DDH family history on the progression after the onset of hip osteoarthritis (OA).
Medical interviews about detailed clinical information including family history were conducted on 298 consecutive patients who had undergone surgery for OA due to DDH. Clinical or radiographic items that are associated with the severity of DDH (total hip arthroplasty [THA], involvement of bilateral DDH, onset age of hip pain, and three radiological indices of DDH: center-edge angle, sharp angle, and acetabular roof obliquity) were collected and evaluated in multivariate analyses for their associations with DDH family history in a qualitative or quantitative manner. Survival time analyses for THA as the endpoint was also performed to evaluate the effects of DDH family history on the progression of OA.
The DDH family history showed significant associations with bilateral involvement of DDH (odds ratio = 2.09 [95% confidence interval {CI} 1.05 to 4.16]; P = .037), early onset of hip pain (P = .0065), and radiological severity of DDH (P = .016). The DDH family history showed a significant association with undergoing THA (odds ratio = 2.25 [95% CI 1.09 to 4.66]; P = .029), further supported by the Cox regression analyses (hazards ratio = 1.56 [95% CI 1.15 to 2.11]; P = .0044).
A DDH family history is a risk factor for the progression of hip OA. Stronger genetic predisposition to DDH leads to faster onset and progression of hip OA.
发育性髋关节发育不良(DDH)被认为具有遗传易感性,并在许多家族中出现。然而,目前尚无研究评估 DDH 家族史对髋关节骨关节炎(OA)发病后的进展的影响。
对 298 例因 DDH 行 OA 手术的连续患者进行了详细的临床信息医学访谈,包括家族史。收集并评估了与 DDH 严重程度相关的临床或影像学项目(全髋关节置换术[THA]、双侧 DDH 受累、髋关节疼痛发病年龄和 DDH 的三个影像学指标:中心边缘角、锐度角和髋臼顶倾斜度),并以定性或定量的方式在多变量分析中评估其与 DDH 家族史的关系。还进行了以 THA 为终点的生存时间分析,以评估 DDH 家族史对 OA 进展的影响。
DDH 家族史与双侧 DDH 受累(优势比=2.09[95%置信区间{CI}1.05 至 4.16];P=0.037)、髋关节疼痛发病早(P=0.0065)和 DDH 的影像学严重程度(P=0.016)显著相关。DDH 家族史与接受 THA 显著相关(优势比=2.25[95%CI1.09 至 4.66];P=0.029),Cox 回归分析进一步支持了这一结果(风险比=1.56[95%CI1.15 至 2.11];P=0.0044)。
DDH 家族史是髋关节 OA 进展的危险因素。对 DDH 更强的遗传易感性导致髋关节 OA 发病更早、进展更快。