Fox K M, Hochberg M C, Resnik C S, Kenzora J E, Hebel J R, Zimmerman S I, Hudson J, Magaziner J
Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, USA.
J Rheumatol. 1996 Apr;23(4):693-7.
The decision to perform total hip arthroplasty (THA) in patients with osteoarthritis (OA) of the hip is based largely on patients' reports of pain and disability and not on radiographic findings of OA. We determine the severity of radiographic OA and its association with disability in patients undergoing THA.
Individual radiographic features (osteophytes, joint space narrowing, sclerosis, cysts, deformity) and global severity of hip OA were assessed in 95 consecutive elderly patients with hip OA undergoing THA who were enrolled in a Patient Outcome Research Team (PORT) project.
Eighty-seven patients (91.5%) had either severe or moderate OA in the hip to be replaced; 17% of these had a previous contralateral THA. Only 8 patients (8.4%) had mild or no signs of OA in the hip to be replaced and 4 (50%) of these patients had their opposite hip replaced previously.
These data indicate that radiographic features of moderate to severe hip OA are associated with clinical findings and the necessity to perform THA in the majority of patients. Patients who have had a prior hip replacement, however, may be more likely to have a contralateral replacement done earlier (p = 0.03), before radiographic signs are evident.
髋关节骨关节炎（OA）患者行全髋关节置换术（THA）的决策主要基于患者的疼痛和残疾报告，而非OA的影像学表现。我们确定接受THA患者的影像学OA严重程度及其与残疾的关联。
对连续95例纳入患者结局研究团队（PORT）项目的老年髋关节OA患者进行THA，评估其个体影像学特征（骨赘、关节间隙狭窄、硬化、囊肿、畸形）及髋关节OA的整体严重程度。
87例（91.5%）患者拟置换髋关节存在重度或中度OA；其中17%曾行对侧THA。仅8例（8.4%）患者拟置换髋关节有轻度OA或无OA体征，其中4例（50%）患者对侧髋关节曾行置换。
这些数据表明，中重度髋关节OA的影像学特征与临床发现相关，且大多数患者有必要行THA。然而，既往行髋关节置换的患者可能更易在影像学征象出现之前更早地接受对侧置换（p = 0.03）。
