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Predictors of total hip replacement in community based older adults: a cohort study


Mezhov, V and Laslett, LL and Ahedi, H and Blizzard, CL and Aspden, RM and Gregory, JS and Saunders, FR and Munugoda, IP and Cai, G and Cicuttini, F and Graves, SE and Lorimer, M and Jones, G, Predictors of total hip replacement in community based older adults: a cohort study, Osteoarthritis and Cartilage Article online ahead of print. ISSN 1063-4584 (2021) [Refereed Article]

DOI: doi:10.1016/j.joca.2021.04.013


Objective: The purpose of this study is to describe predictors of total hip replacement (THR) in community dwelling older adults. A better understanding of predictors of THR can aid in triaging patients and researching preventative strategies.

Design: At baseline, participants had assessment of radiographic OA and cam morphology (from pelvic radiographs), shape mode scores and hip bone mineral density (BMD; from dual energy X-ray absorptiometry (DXA)). After 2.6 and 5 years, participants reported hip pain using WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index), and had hip structural changes assessed using magnetic resonance imaging (MRI). Risk of THR was analysed using mixed-effect Poisson regression.

Results: Incidence of THR for OA over 14 years was 4.6% (37/801). As expected, WOMAC hip pain and hip radiographic OA both predicted risk of THR. Additionally, shape mode 2 score (decreasing acetabular coverage) (RR 1.83 per SD; 95% CI 1.13.04), shape mode 4 score (non-spherical femoral head) (RR 0.59/SD; 95% CI 0.360.96), cam morphology (α > 60) (RR 2.2/SD; 95% CI 1.333.36), neck of femur BMD (RR 2.09/SD, 95% CI 1.482.94) and bone marrow lesions (BMLs) increased risk of THR (RR 7.10/unit; 95% CI 1.0946.29).

Conclusion: In addition to hip pain and radiographic hip OA, measures of hip shape, cam morphology, BMD and BMLs independently predict risk of THR. This supports the role of hip bone geometry and structure in the pathogenesis of end stage hip OA and has identified factors that can be used to improve prediction models for THR.

Item Details

Item Type:Refereed Article
Keywords:hip osteoarthritis, total hip replacement, bone shape, bone mineral density, cam morphology, bone marrow lesions, predictors
Research Division:Biomedical and Clinical Sciences
Research Group:Clinical sciences
Research Field:Orthopaedics
Objective Division:Health
Objective Group:Clinical health
Objective Field:Diagnosis of human diseases and conditions
UTAS Author:Laslett, LL (Dr Laura Laslett)
UTAS Author:Ahedi, H (Ms Harbeer Ahedi)
UTAS Author:Blizzard, CL (Professor Leigh Blizzard)
UTAS Author:Cai, G (Dr Guoqi Cai)
UTAS Author:Jones, G (Professor Graeme Jones)
ID Code:144492
Year Published:2021
Funding Support:National Health and Medical Research Council (1070586)
Web of Science® Times Cited:1
Deposited By:Menzies Institute for Medical Research
Deposited On:2021-05-26
Last Modified:2021-06-02

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