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骨盆形态与放射学髋关节骨关节炎的发展密切相关,在 10 年内的 4 次随访中均表现出一致性。

Cam morphology is strongly and consistently associated with development of radiographic hip osteoarthritis throughout 4 follow-up visits within 10 years.

机构信息

Department of Orthopedics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.

Department of General Practice, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.

出版信息

Osteoarthritis Cartilage. 2023 Dec;31(12):1650-1656. doi: 10.1016/j.joca.2023.08.006. Epub 2023 Aug 19.

Abstract

OBJECTIVE

To determine the association between cam morphology and the development of radiographic hip osteoarthritis (RHOA) at four time points within 10-year follow-up.

DESIGN

The nationwide prospective Cohort Hip and Cohort Knee study includes 1002 participants aged 45-65 years with 2-, 5-, 8-, and 10-year follow-ups. The associations of cam morphology (alpha angle >60°) and large cam morphology (alpha angle >78°) in hips free of osteoarthritis at baseline (Kellgren & Lawrence (KL) grade <2) with the development of both incident RHOA (KL grade≥2) and end-stage RHOA (KL grade≥3) were estimated using logistic regression with generalized estimating equation at each follow-up and using Cox regression over 10 years, adjusted for age, sex, and body mass index.

RESULTS

Both cam morphology and large cam morphology were associated with the development of incident RHOA at all follow-ups with adjusted Odd Ratios (aORs) ranging from 2.7 (95% Confidence interval 1.8-4.1) to 2.9 (95% CI 2.0-4.4) for cam morphology and ranging from 2.5 (95% CI 1.5-4.3) to 4.2 (95% CI 2.2-8.3) for large cam morphology. For end-stage RHOA, cam morphology resulted in aORs ranging from 4.9 (95% CI 1.8-13.2) to 8.5 (95% CI 1.1-64.4), and aORs for large cam morphology ranged from 6.7 (95% CI 3.1-14.7) to 12.7 (95% CI 1.9-84.4).

CONCLUSIONS

Cam morphology poses the hip at 2-13 times increased odds for developing RHOA within a 10-year follow-up. The association was particularly strong for large cam morphology and end-stage RHOA, while the strength of association was consistent over time.

摘要

目的

在 10 年随访的 4 个时间点内,确定凸轮形态与放射学髋关节骨关节炎(RHOA)发展之间的关联。

设计

全国性前瞻性髋关节和膝关节队列研究包括 1002 名年龄在 45-65 岁之间的参与者,随访时间分别为 2、5、8 和 10 年。在基线时(Kellgren 和 Lawrence(KL)分级<2)无骨关节炎的髋关节中,凸轮形态(α角>60°)和大凸轮形态(α角>78°)与新发 RHOA(KL 分级≥2)和终末期 RHOA(KL 分级≥3)的发展之间的关联,使用在每个随访时使用广义估计方程的逻辑回归和在 10 年内使用 Cox 回归进行评估,调整年龄、性别和体重指数。

结果

凸轮形态和大凸轮形态均与所有随访中 RHOA 的新发发展相关,调整后的优势比(aOR)范围为 2.7(95%置信区间 1.8-4.1)至 2.9(95%CI 2.0-4.4)为凸轮形态,范围为 2.5(95%CI 1.5-4.3)至 4.2(95%CI 2.2-8.3)为大凸轮形态。对于终末期 RHOA,凸轮形态导致 aOR 范围为 4.9(95%CI 1.8-13.2)至 8.5(95%CI 1.1-64.4),大凸轮形态的 aOR 范围为 6.7(95%CI 3.1-14.7)至 12.7(95%CI 1.9-84.4)。

结论

凸轮形态使髋关节在 10 年随访期间发生 RHOA 的可能性增加了 2-13 倍。这种关联对于大凸轮形态和终末期 RHOA 尤为强烈,而关联的强度随着时间的推移是一致的。

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