Prevalence of Radiographic and Symptomatic Hip Osteoarthritis in an Urban United States Community: The Framingham Osteoarthritis Study

Abstract

Objectives The last prevalence survey encompassing urban populations was part of the nationwide Health and Nutrition examination survey (NHANES I) in the 1970's. We carried out a prevalence survey for hip osteoarthritis (OA) in the Framingham Study Community cohort. Methods Persons age 50 and older living in Framingham in 2002 – 2005 were recruited by random digit dialing without respect to joint pain or arthritis. Anteroposterior standing long-limb radiographs of the lower extremities including the pelvis were obtained and read for radiographic hip OA (ROA) by two trained physicians with all possible cases of ROA confirmed by an experienced musculoskeletal radiologist. ROA was defined as Kellgren-Lawrence score ≥ 2. Using a homunculus in which the hip joint was depicted, participants were asked whether they had hip pain on most days. Those who said ‘yes’ were defined as having hip pain. Symptomatic hip OA (SxOA) was defined as radiographic OA with ipsilateral hip pain. We defined a person as having hip OA if at least one of their hip joints was affected. Results Of 978 subjects studied (mean age 63.5 years; 56% women), age-standardized prevalence of ROA was 19.6% (95% CI 16.7%-23.0%) and SxOA was 4.2% (95% CI 2.9%-6.1%%). Overall, we found that men had higher prevalence of ROA (p<0.0001) compared to women, but men did not have a higher prevalence of SxOA compared to women (5.2% vs 3%, p=0.08). Conclusion In conclusion, hip osteoarthritis is a common condition in middle aged and older persons in urban and suburban U.S.

Economic and Humanistic Burden of Osteoarthritis: A Systematic Review of Large Sample Studies

“…We included studies if they: (1) included human patients with OA, (2) had a sample size C1000, (3) reported the cost of OA (i.e., the total cost with or without cost subcategories) and/or HRQoL (either in summary or by domains such as pain, physical, or mental functioning) of OA, (4) were published between May 2006 and March 4, 2016, and (5) were in English. We excluded studies that reported costs or cost effectiveness associated with specific treatments of OA.…”

“…The prevalence of radiographic and symptomatic knee OA was 37.4 and 12.1 %, respectively, using the Third National Health and Nutrition Examination Survey data in the USA [3]. The Framingham Osteoarthritis Study estimated that the prevalence of radiographic and symptomatic hip OA was 19.6 and 4.2 %, respectively [4]. In Canada, the prevalence of selfreported OA was 14.8 % with 10.5 % on the knee and 8.5 % on the hip [5].…”

Hip Osteoarthritis: Etiopathogenesis and Implications for Management

“…These marked differences in prevalence can be attributed to differences in risk factor profiles between the populations sampled. The two largest USA-based prevalence surveys, the Johnston County Osteoarthritis Project [18] and Framingham Osteoarthritis Study [16], found prevalence rates of 10% and 4.2%, respectively. The higher prevalence in the Johnston County Project is likely due to this rural population containing a much higher proportion of farmers and African Americans, both of which are independent risk factors for hip OA [18].…”

“…Counter-intuitively, the same meta-analysis found an increased incidence of hip OA in females, although there were only two such studies used for pooling in this meta-analysis because studies looking at OA incidence are less common. The Framingham Osteoarthritis Study found a higher prevalence of radiographic hip OA in men compared to women, but no significant difference in symptomatic hip OA risk [16]. …”

The Association between Osteoarthritis and Occupational Clusters in the Korean Population: A Nationwide Study

“…Generally, examination for OA has not been included in standard checkups, and OA has gone largely unobserved. Moreover, symptoms of OA are not correlated with radiologic findings [8,9], and severe radiological OA with pathological progression is often seen in patients who are asymptomatic or have mild symptoms.…”