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Published on: September 29, 2018
Predictors of the need for total hip replacement in patients with osteoarthritis of the hip
C Vinciguerra1, A Gueguen, M Revel
1Rheumatology Department, Cochin Teaching Hospital, Paris, France.
Insights
Older age, higher BMI, and severe joint narrowing predict total hip replacement in hip osteoarthritis patients. These factors indicate a potentially severe disease course requiring further investigation.
Area of Science:
- Orthopedics
- Rheumatology
- Epidemiology
Background:
- The natural history and risk factors for hip osteoarthritis remain incompletely understood.
- Identifying predictors for disease progression is crucial for patient management.
Purpose of the Study:
- To identify factors that predict the need for total hip replacement (THR) in patients with hip osteoarthritis.
- To understand the progression of hip osteoarthritis and associated risk factors.
Main Methods:
- Retrospective study of 149 outpatients diagnosed with hip osteoarthritis between 1981 and 1986.
- Kaplan-Meier method to estimate the risk of THR; Cox proportional hazard models for variable analysis.
- Analysis of patient characteristics, hip disease severity, and radiological findings at diagnosis.
Main Results:
- An estimated 36% of patients required THR within five years of diagnosis.
- Significant predictors for THR included age over 54 (RR 3.15), BMI over 27 (RR 2.97), and severe joint space narrowing (RR 2.26).
Conclusions:
- Hip osteoarthritis can have a severe disease course.
- Age, obesity, and joint space narrowing are key factors associated with rapid hip osteoarthritis progression and the need for total hip replacement.
Rationale:
the natural history and risk factors for hip osteoarthritis are still unknown.
Objective:
to identify factors predicting a need for total hip replacement at some time during the course of hip osteoarthritis.
Patients And Methods:
outpatients evaluated between 1981 and 1986 for hip osteoarthritis were studied retrospectively. The date of diagnosis and the characteristics of the patients and hip disease at diagnosis were recorded. The risk of eventual total hip replacement was estimated using the Kaplan-Meier method. Uni- and multivariate Cox proportional hazard models were used to determine the value of each variable for predicting total hip replacement.
Results:
we included 149 patients (50 males). The risk of total hip replacement was estimated at 36 +/- 4% five years after diagnosis. Factors with significant effects in the multivariate analysis were age older than 54 years at diagnosis (relative risk 3.15), body mass index greater than 27 (relative risk 2.97), and severe radiological joint space narrowing at diagnosis (relative risk 2.26).
Conclusion:
this study confirmed the often severe course of hip osteoarthritis and identified several factors possibly associated with rapid progression.
