Predictive factors of total hip replacement due to primary osteoarthritis: a prospective 2 year study of 505 patients
Open Access
- 1 July 2005
- journal article
- other
- Published by BMJ in Annals Of The Rheumatic Diseases
- Vol. 64 (7), 1028-1032
- https://doi.org/10.1136/ard.2004.029546
Abstract
Objectives: To determine the 2 year total hip replacement (THR) rate and to identify factors predictive of THR due to primary osteoarthritis (OA). Methods: A 2 year prospective cohort study. Inclusion criteria were primary hip OA, with a history of pain for 6 months, and patients’ pain assessment of ⩾30 mm on a visual analogue scale (0–100 mm). Predictive factors of THR were identified by univariate then multivariate analysis using logistic regression. Potential predictors considered were demographic, radiographic (localisation and severity of OA), and patients’ assessment of symptomatic severity of OA. Results: Of the 741 patients enrolled, 505 (68.2%) patients, mean (SD) age 64.0 (10.1) years, mean (SD) disease duration 4.7 (5.2) years, had complete 2 year data. There was no difference between the completer and non-completer groups. During follow up, 189/505 (37.4%) patients had a first THR. By multivariate analysis, predictors of THR were Kellgren-Lawrence radiographic grade (grade III: odds ratio (OR) = 3.3 (95% confidence interval (95% CI) 1.7 to 6.4); grade IV: OR = 5.3 (95% CI 2.6 to 10.8)), high mean patient global assessment during the first 6 months (OR = 2.2 (95% CI 1.4 to 3.2)), and previous non-steroidal anti-inflammatory drug (NSAID) intake (OR = 1.5 (95% CI 1.0 to 2.4)). For two of these factors together, OR = 3.0 (95% CI 1.6 to 5.9), for three factors together, OR = 5.6 (95% CI 2.6 to 12.2). Conclusion: The 2 year rate of THR was high in this group of patients with painful hip OA: 37.4%. Radiological grade, mean patient global assessment, and the need for NSAIDs were predictive of THR.This publication has 30 references indexed in Scilit:
- Management of osteoarthritis (OA) with an unsupervised home based exercise programme and/or patient administered assessment tools. A cluster randomised controlled trial with a 2x2 factorial designAnnals Of The Rheumatic Diseases, 2004
- Predictors of hip joint replacement in new attenders in primary care with hip pain.2003
- The effect of education and income on need and willingness to undergo total joint arthroplastyArthritis & Rheumatism, 2002
- Prognostic factors of progress of hip osteoarthritis: A systematic reviewArthritis Care & Research, 2002
- Risk factors for total hip replacement due to primary osteoarthritis: A cohort study in 50,034 personsArthritis & Rheumatism, 2002
- Evaluation of the structure-modifying effects of diacerein in hip osteoarthritis: ECHODIAH, a three-year, placebo-controlled trialArthritis & Rheumatism, 2001
- The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC): a review of its utility and measurement propertiesArthritis & Rheumatism, 2001
- A report of the Osteoarthritis Research Society International Standing Committee for Clinical Trials Response Criteria InitiativeOsteoarthritis and Cartilage, 2000
- Differences between Men and Women in the Rate of Use of Hip and Knee ArthroplastyThe New England Journal of Medicine, 2000
- Radiological Assessment of Osteo-ArthrosisAnnals Of The Rheumatic Diseases, 1957