Abstract
We investigated the radiological and epidemiological data of 4,151 subjects followed up from 1976 to 2003 to determine individual risk factors for hip osteoarthritis (OA), hip pain and/or treatment by total hip replacement (THR). Pelvic radiographs recorded in 1992 were assessed for evidence of hip-joint degeneration and dysplasia. Sequential body mass index (BMI) measurements from 1976 to 1992, age, exposure to daily lifting and hip dysplasia were entered into logistic regression analyses. The prevalence of hip dysplasia ranged from 5.4% to 12.8% depending on the radiographical index used. Radiological hip OA prevalence was 1.0–2.5% in subjects <60 years of age and 4.4–5.3% in subjects ≥60 years of age. While radiological OA was significantly influenced by hip dysplasia in men and hip dysplasia and age in women, the risk of THR being performed was only influenced by BMI assessed in 1976. Hip-joint degeneration and treatment by THR do not necessarily share the same risk factors, and caution should be exercised in epidemiological studies in attributing one or the other as the end point of coxarthrosis.
Résumé
Nous avons enquêté sur des données radiologiques et épidémiologiques de 4.151 sujets suivi de 1976 à 2003 pour déterminer des facteurs de risque individuels d’arthrose de la hanche, de douleurs de la hanche et/ou du traitement par prothèse totale de hanche (PTH). Les radiographies pelviennes enregistrées en 1992 ont été réparties selon l’atteinte dégénérative de la hanche et la dysplasie. La valeur de l’index de masse corporelle séquentielle de 1976 à 1992, l’âge, l’activité quotidienne et la dysplasie de la hanche sont entrées dans une analyse de régression. La prédominance de la dysplasie de la hanche s’étend de 5,4% à 12,8% selon l’index radiographique utilisé. La prédominance de l’arthrose radiologique était de 1,0 à 2,5% chez les sujets de moins de 60 ans, et de 4,4 à 5,3% chez les sujets de 60 ans ou plus. Tandis que l’arthrose radiologique était significativement influencée par la dysplasie de la hanche chez les hommes, par la dysplasie et l’âge chez les femmes, le risque de réalisation d’une PTH était seulement influencé par l’index de masse corporelle mesuré en 1976. La dégénérescence de la hanche et le traitement par PTH ne partagent pas nécessairement les mêmes facteurs de risque, et la prudence dans les études épidémiologiques devrait être de nommer l’un ou l’autre comme l’événement final de la coxarthrose.
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