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Hip osteoarthritis and dysplasia in Chinese men
1Department of Community and Family Medicine, Chinese University of Hong Kong, Hong Kong.
Insights
Hip osteoarthritis is less common in Hong Kong men than British men. However, hip dysplasia prevalence is similar, suggesting dysplasia doesn't solely explain osteoarthritis frequency differences.
Area of Science:
- Orthopedics
- Radiology
- Epidemiology
Background:
- Hip osteoarthritis (OA hip) prevalence varies globally.
- Hip dysplasia is a potential risk factor for OA hip.
- Understanding regional differences in OA hip and hip dysplasia is crucial for public health.
Purpose of the Study:
- To determine the prevalence of hip osteoarthritis and hip dysplasia in Hong Kong men.
- To compare these prevalences with data from British men.
- To investigate the relationship between hip dysplasia and OA hip.
Main Methods:
- Radiographic review of 999 Hong Kong men (aged 60-75) using postmicturition pelvic films.
- Diagnosis of OA hip based on Kellgren and Lawrence criteria or joint space narrowing (≤1.5 mm).
- Diagnosis of hip dysplasia based on center-edge angle (<25°) or acetabular depth (<9 mm).
Main Results:
- Hong Kong men had approximately 50% the prevalence of OA hip features compared to British men (5.4% vs. 11.0%).
- Severe joint space narrowing (≤1.5 mm) was less common in Hong Kong (0.7%) than British men (2%).
- Prevalence of shallow acetabular depth was higher in Hong Kong Chinese (14.5%) than British men (2.1%), while center-edge angle prevalence was similar.
Conclusions:
- Radiographic hip osteoarthritis is less prevalent in Hong Kong men than British men.
- Acetabular dysplasia prevalence is similar between Hong Kong Chinese and British men.
- Hip dysplasia prevalence does not fully explain the observed differences in hip osteoarthritis frequency.
Objective:
To estimate the prevalence of hip osteoarthritis (OA hip) and hip dysplasia in a sample of Hong Kong men who were unselected with respect to hip symptoms.
Methods:
The postmicturition films of 999 men aged 60-75 years, consecutive attenders for intravenous urography between 1987 and 1990 at a regional hospital, were reviewed. OA hip was diagnosed as the occurrence of two or more features of OA using a modified version of the Kellgren and Lawrence scale, or a minimal joint space of 1.5 mm or less. Hip dysplasia was defined as a centre-edge angle of less than 25 degrees, or an acetabular depth of less than 9 mm. The results were compared with British data obtained by similar methods.
Results:
In the Hong Kong sample, the proportion of men with two or more features of osteoarthritis in at least one hip was about 50% that of the men in the British study (5.4% and 11.0%, respectively). Severe joint space narrowing (of 1.5 mm or less) occurred in 0.7% of the hips in Hong Kong men, compared with 2% in the British men. The proportion of hips with centre-edge angles less than 25 degrees was 4.5% in Hong Kong, compared with 3.6% in Britain, and the prevalence of shallow acetabular depth was greater in Chinese (14.5%) than in the British (2.1%). Radiographic measures of hip dysplasia were not associated with minimal joint space.
Conclusions:
Our results have confirmed the lower prevalence of radiographic hip osteoarthritis in Hong Kong men compared with British men. However, acetabular dysplasia was as prevalent among Chinese men as in the British sample. This is evidence against the hypothesis that variations in the frequency of hip osteoarthritis are caused by differences in the occurrence of hip dysplasia.
