Skip to main content
PMC home page
Annals of the Rheumatic Diseases logoLink to Annals of the Rheumatic Diseases
. 2003 Oct;62(10):931–934. doi: 10.1136/ard.62.10.931

Sex differences in hip osteoarthritis: results of a longitudinal study in 508 patients

J Maillefert 1, A Gueguen 1, M Monreal 1, M Nguyen 1, L Berdah 1, M Lequesne 1, B Mazieres 1, E Vignon 1, M Dougados 1
PMCID: PMC1754339  PMID: 12972469

Abstract

Objective: To evaluate sex differences in the clinical and structural presentation, and natural history of hip OA.

Methods: A multicentre, prospective, longitudinal, five year follow up study of 508 patients (302 women, 206 men, mean age 63 (7) years) with painful hip OA. Data collected were baseline demographics, symptomatic, therapeutic, and structural variables; symptomatic variables and changes in joint space width (JSW) during the first year's follow up; requirement for total hip arthroplasty (THA) between the end of the first and fifth years. Statistical analysis: evaluation of sex differences (a) at baseline, in the main characteristics of hip OA using multivariate logistic regression; (b) during the first year of follow up, in the radiological progression of the disease; (c) during the five years of follow up, in the requirement for THA using Kaplan-Meier curves and the log rank test, and of the parameters related to THA, using a multivariate Cox analysis.

Results: At entry, women presented more frequently than men with polyarticular OA (mean (SD) articular score 306 (162) v 235 (127)), and superomedial migration of the femoral head (40% v 19%), and had more severe symptomatic disease (patient's overall assessment 46 (23) v 40 (26)). The change in JSW did not differ between women and men after one year, but a greater proportion of women had rapid structural progression (OR=2.34, 95% CI 1.1 to 5.2). THA was performed more often in women. Multivariate analysis suggested that the decision to perform surgery was related more closely to the symptomatic and structural severity of the disease than to the sex of the patient.

Conclusion: Hip OA in women is more frequently part of a polyarticular OA, and displays greater symptomatic and structural severity.

Full Text

The Full Text of this article is available as a PDF (133.7 KB).

Figure 1.

Figure 1

Open in a new tab

Kaplan-Meier estimates of the cumulative probabilities of not undergoing THA, between the ends of years 1 and 5, according to sex, in painful hip OA.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Altman R., Alarcón G., Appelrouth D., Bloch D., Borenstein D., Brandt K., Brown C., Cooke T. D., Daniel W., Feldman D. The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hip. Arthritis Rheum. 1991 May;34(5):505–514. doi: 10.1002/art.1780340502. [DOI] [PubMed] [Google Scholar]
  2. Auquier L., Paolaggi J. B., Cohen de Lara A., Siaud J. R., Limon J., Emery J. P., Forestier J., Forestier F. Evolution à long terme de la douleur dans une série de 273 coxarthroses. Rev Rhum Mal Osteoartic. 1979 Mar;46(3):153–162. [PubMed] [Google Scholar]
  3. Dougados M., Gueguen A., Nguyen M., Berdah L., Lequesne M., Mazieres B., Vignon E. Requirement for total hip arthroplasty: an outcome measure of hip osteoarthritis? J Rheumatol. 1999 Apr;26(4):855–861. [PubMed] [Google Scholar]
  4. Dougados M., Gueguen A., Nguyen M., Thiesce A., Listrat V., Jacob L., Nakache J. P., Gabriel K. R., Lequesne M., Amor B. Longitudinal radiologic evaluation of osteoarthritis of the knee. J Rheumatol. 1992 Mar;19(3):378–384. [PubMed] [Google Scholar]
  5. Dougados M., Nguyen M., Berdah L., Maziéres B., Vignon E., Lequesne M., ECHODIAH Investigators Study Group Evaluation of the structure-modifying effects of diacerein in hip osteoarthritis: ECHODIAH, a three-year, placebo-controlled trial. Evaluation of the Chondromodulating Effect of Diacerein in OA of the Hip. Arthritis Rheum. 2001 Nov;44(11):2539–2547. doi: 10.1002/1529-0131(200111)44:11<2539::aid-art434>3.0.co;2-t. [DOI] [PubMed] [Google Scholar]
  6. Felson D. T. Epidemiology of hip and knee osteoarthritis. Epidemiol Rev. 1988;10:1–28. doi: 10.1093/oxfordjournals.epirev.a036019. [DOI] [PubMed] [Google Scholar]
  7. Hawker G. A., Wright J. G., Coyte P. C., Williams J. I., Harvey B., Glazier R., Badley E. M. Differences between men and women in the rate of use of hip and knee arthroplasty. N Engl J Med. 2000 Apr 6;342(14):1016–1022. doi: 10.1056/NEJM200004063421405. [DOI] [PubMed] [Google Scholar]
  8. Hoaglund F. T., Yau A. C., Wong W. L. Osteoarthritis of the hip and other joints in southern Chinese in Hong Kong. J Bone Joint Surg Am. 1973 Apr;55(3):545–557. [PubMed] [Google Scholar]
  9. Hochberg M. C., Altman R. D., Brandt K. D., Clark B. M., Dieppe P. A., Griffin M. R., Moskowitz R. W., Schnitzer T. J. Guidelines for the medical management of osteoarthritis. Part I. Osteoarthritis of the hip. American College of Rheumatology. Arthritis Rheum. 1995 Nov;38(11):1535–1540. doi: 10.1002/art.1780381103. [DOI] [PubMed] [Google Scholar]
  10. Hochberg M. C., Lane N. E., Pressman A. R., Genant H. K., Scott J. C., Nevitt M. C. The association of radiographic changes of osteoarthritis of the hand and hip in elderly women. J Rheumatol. 1995 Dec;22(12):2291–2294. [PubMed] [Google Scholar]
  11. Ingvarsson T., Hägglund G., Lohmander L. S. Prevalence of hip osteoarthritis in Iceland. Ann Rheum Dis. 1999 Apr;58(4):201–207. doi: 10.1136/ard.58.4.201. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Jørring K. Osteoarthritis of the hip. Epidemiology and clinical role. Acta Orthop Scand. 1980 Jun;51(3):523–530. doi: 10.3109/17453678008990835. [DOI] [PubMed] [Google Scholar]
  13. Katz J. N., Wright E. A., Guadagnoli E., Liang M. H., Karlson E. W., Cleary P. D. Differences between men and women undergoing major orthopedic surgery for degenerative arthritis. Arthritis Rheum. 1994 May;37(5):687–694. doi: 10.1002/art.1780370512. [DOI] [PubMed] [Google Scholar]
  14. Kelsey J. L., Hochberg M. C. Epidemiology of chronic musculoskeletal disorders. Annu Rev Public Health. 1988;9:379–401. doi: 10.1146/annurev.pu.09.050188.002115. [DOI] [PubMed] [Google Scholar]
  15. Lawrence R. C., Helmick C. G., Arnett F. C., Deyo R. A., Felson D. T., Giannini E. H., Heyse S. P., Hirsch R., Hochberg M. C., Hunder G. G. Estimates of the prevalence of arthritis and selected musculoskeletal disorders in the United States. Arthritis Rheum. 1998 May;41(5):778–799. doi: 10.1002/1529-0131(199805)41:5<778::AID-ART4>3.0.CO;2-V. [DOI] [PubMed] [Google Scholar]
  16. Ledingham J., Dawson S., Preston B., Milligan G., Doherty M. Radiographic patterns and associations of osteoarthritis of the hip. Ann Rheum Dis. 1992 Oct;51(10):1111–1116. doi: 10.1136/ard.51.10.1111. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Ledingham J., Dawson S., Preston B., Milligan G., Doherty M. Radiographic progression of hospital referred osteoarthritis of the hip. Ann Rheum Dis. 1993 Apr;52(4):263–267. doi: 10.1136/ard.52.4.263. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Lequesne M. G., Mery C., Samson M., Gerard P. Indexes of severity for osteoarthritis of the hip and knee. Validation--value in comparison with other assessment tests. Scand J Rheumatol Suppl. 1987;65:85–89. doi: 10.3109/03009748709102182. [DOI] [PubMed] [Google Scholar]
  19. Odding E., Valkenburg H. A., Algra D., Vandenouweland F. A., Grobbee D. E., Hofman A. Associations of radiological osteoarthritis of the hip and knee with locomotor disability in the Rotterdam Study. Ann Rheum Dis. 1998 Apr;57(4):203–208. doi: 10.1136/ard.57.4.203. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Spector T. D., Campion G. D. Generalised osteoarthritis: a hormonally mediated disease. Ann Rheum Dis. 1989 Jun;48(6):523–527. doi: 10.1136/ard.48.6.523. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Tepper S., Hochberg M. C. Factors associated with hip osteoarthritis: data from the First National Health and Nutrition Examination Survey (NHANES-I). Am J Epidemiol. 1993 May 15;137(10):1081–1088. doi: 10.1093/oxfordjournals.aje.a116611. [DOI] [PubMed] [Google Scholar]
  22. van Saase J. L., van Romunde L. K., Cats A., Vandenbroucke J. P., Valkenburg H. A. Epidemiology of osteoarthritis: Zoetermeer survey. Comparison of radiological osteoarthritis in a Dutch population with that in 10 other populations. Ann Rheum Dis. 1989 Apr;48(4):271–280. doi: 10.1136/ard.48.4.271. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Annals of the Rheumatic Diseases are provided here courtesy of BMJ Publishing Group

RESOURCES