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

Mezhov, Veronica; Laslett, L.; Ahedi, H.; Blizzard, CL; Aspden, Richard M.; Gregory, J.S.; Saunders, Fiona; Munugoda, I.P.; Cai, Guoqi; Cicuttini, F.; Jones, Gary L.

doi:10.21203/rs.2.19476/v1

Cited by 3 publications

(6 citation statements)

References 15 publications

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“…The application of SSM to study hip morphology has been in large part limited to 2D radiographs or small regions of the joint or bone. In 2D applications, femur and pelvis shape characteristics have been identified as relevant to the incidence of OA, including modes of variation representing morphology consistent with DDH and those found herein 19–23 . To our knowledge, only one 3D SSM study evaluated the region of the joint in DDH patients and asymptomatic participants.…”

Section: Discussionmentioning

confidence: 99%

“…The shape variability of the hip joint in patients with DDH has also been evaluated using 2D radiographs in combination with manual landmark identification, 19–23 but these analyses suffer from similar limitations to those associated with 2D coverage measurements and cannot capture the complete morphology of the two bones. Clinical adoption of computed tomography (CT) and magnetic resonance imaging (MRI) provides the ability to quantify both global and regional coverage deficiencies and concomitant deformities in patients with DDH through 3D surface reconstructions of the anatomy 15,24–27 .…”

Section: Introductionmentioning

confidence: 99%

“…3D SSM of the femur has been used to objectively identify the region of the proximal femur that is most affected by cam femoroacetabular impingement syndrome 30 and identify large variations in femoral version, neck-shaft angle, and femoral neck length in patients with DDH. 31 However, to date, most SSM studies that have quantified morphology of the hip joint have been limited to 2D bone contours, [19][20][21][22][23] which limits the ability to use these models to fully describe the specific pathology of the joint.…”

Section: Introductionmentioning

confidence: 99%

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Prediction of femoral head coverage from articulated statistical shape models of patients with developmental dysplasia of the hip

Atkins

Agrawal

Mozingo

et al. 2021

Journal Orthopaedic Research

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Developmental dysplasia of the hip (DDH) is commonly described as reduced femoral head coverage due to anterolateral acetabular deficiency. Although reduced coverage is the defining trait of DDH, more subtle and localized anatomic features of the joint are also thought to contribute to symptom development and degeneration.These features are challenging to identify using conventional approaches. Herein, we assessed the morphology of the full femur and hemi-pelvis using an articulated statistical shape model (SSM). The model determined the morphological and posebased variations associated with DDH in a population of Japanese females and established which of these variations predict coverage. Computed tomography (CT) images of 83 hips from 47 patients were segmented for input into a correspondence-based SSM. The dominant modes of variation in the model initially represented scale and pose. After removal of these factors through individual bone alignment, femoral version and neck-shaft angle, pelvic curvature, and acetabular version dominated the observed variation. Femoral head oblateness and prominence of the acetabular rim and various muscle attachment sites of the femur and hemipelvis were found to predict 3D CT-based coverage measurements (R 2 = 0.5-0.7 for the full bones, R 2 = 0.9 for the joint). Statement of Clinical Significance: Currently, clinical measurements of DDH only consider the morphology of the acetabulum. However, the results of this study demonstrated that variability in femoral head shape and several muscle attachment sites were predictive of femoral head coverage. These morphological differences may provide insight into improved clinical diagnosis and surgical planning based on functional adaptations of patients with DDH.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prediction of femoral head coverage from articulated statistical shape models of patients with developmental dysplasia of the hip

Atkins

Agrawal

Mozingo

et al. 2021

Journal Orthopaedic Research

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“…The Tasmanian Older Adult Cohort (TASOAC) is a population-based study including 801 participants aged 50-80. Preliminary analysis from TASOAC showed shape modes (constructed from DEXA images) reflecting decreasing acetabular coverage and femoral head asphericity independently predicted risk of progression to THR [14].…”

Section: Hip Imaging Studiesmentioning

confidence: 99%

Bone in osteoarthritis: imaging and interventions

Khokhar

Conaghan

2021

Current Opinion in Rheumatology

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Purpose of reviewTo review the recent literature on bone in osteoarthritis (OA), with a focus on imaging and intervention studies Recent findingsMost studies focused on knee OA; hip and hand studies were uncommon. Bone shape studies demonstrated that shape changes precede radiographic OA, predict joint replacement, and have demonstrated high responsiveness. Novel quantitative 3D imaging markers (B-score) have better characterized OA severity, including preradiographic OA status. The addition of computerized tomography-derived 3D metrics has improved the prediction of hip joint replacement when compared to radiographs alone. Recent studies of bisphosphonates for knee OA have reported no benefits on pain or bone marrow lesion (BML) size. A meta-analysis on Vitamin D supplementation in knee OA suggested minimal symptom improvement and no benefits on the structure. Cathepsin K inhibition demonstrated reduction in OA bone change progression, but with no symptom benefit. Studies of injections of bone substitutes into BMLs (subchondroplasty) have generally been small and potential benefits remain unclear. SummarySubchondral bone features are associated with pain, incidence and progression of OA. Recent studies have validated quantitative bone shape as a biomarker for OA trials. Trials of bone-targeted OA therapies have been disappointing although cathepsin K inhibition may slow structural progression.

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“…The intra-rater agreement (kappa) for the presence of hip effusion-synovitis was 0.84, and the intra-class correlation coefficient (ICC) for hip effusion-synovitis CSA was 0.97. We have used similar method to assess knee hip effusion-synovitis [8] and also used these measurements in previously published studies [25,26]. For analyses, the population was divided into two groups by median of effusion-synovitis CSA.…”

Section: Quantitative Assessment Of Hip Effusion-synovitismentioning

confidence: 99%

Quantification of hip effusion-synovitis and its cross-sectional and longitudinal associations with hip pain, MRI findings and early radiographic hip OA

Ahedi

Aitken

Blizzard

et al. 2020

BMC Musculoskelet Disord

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Background: Hip effusion-synovitis may be relevant to osteoarthritis (OA) but is of uncertain etiology. The aim of this study was to describe the cross-sectional and longitudinal associations of hip effusion-synovitis with clinical and structural risk factors of OA in older adults. Methods: One hundred ninety-six subjects from the Tasmanian Older Adult Cohort (TASOAC) study with a right hip STIR (Short T1 Inversion Recovery) Magnetic Resonance Imaging (MRI) on two occasions were included. Hip effusion-synovitis CSA (cm 2) was assessed quantitatively. Hip pain was determined by WOMAC (Western Ontario and McMaster Universities Osteoarthritis) while hip bone marrow lesions (BMLs), cartilage defects (femoral and/or acetabular) and high cartilage signal were assessed on MRI. Joint space narrowing (0-3) and osteophytes (0-3) were measured on x-ray using Altman's atlas. Results: Of 196 subjects, 32% (n = 63) had no or a small hip effusion-synovitis while 68% (n = 133) subjects had a moderate or large hip effusion-synovitis. Both groups were similar but those with moderate or large hip effusionsynovitis were older, had higher BMI and more hip pain. Cross-sectionally, hip effusion-synovitis at multiple sites was associated with presence of hip pain [Prevalence ratio (PR):1.42 95%CI:1.05,1.93], but not with severity of hip pain. Furthermore, hip effusion-synovitis size associated with femoral defect (βeta:0.32 95%CI:0.08,0.56). Longitudinally, and incident hip cartilage defect (PR: 2.23 95%CI:1.00, 4.97) were associated with an increase in hip effusion-synovitis CSA. Furthermore, independent of presence of effusion-synovitis, hip BMLs predicted incident (PR:

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

Cited by 3 publications

References 15 publications

Prediction of femoral head coverage from articulated statistical shape models of patients with developmental dysplasia of the hip

Prediction of femoral head coverage from articulated statistical shape models of patients with developmental dysplasia of the hip

Bone in osteoarthritis: imaging and interventions

Quantification of hip effusion-synovitis and its cross-sectional and longitudinal associations with hip pain, MRI findings and early radiographic hip OA

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