Prevalence of generalised osteoarthritis in patients with advanced hip and knee osteoarthritis:: The Ulm Osteoarthritis Study
Prevalence of generalised osteoarthritis in patients with advanced hip and knee osteoarthritis:: The Ulm Osteoarthritis Study
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DOI：
10.1136/ard.57.12.717
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发表时间：
1998-12-01
影响因子：
27.4
通讯作者：
Puhl, W
中科院分区：
文献类型：
--
作者：
Günther, KP;Stürmer, T;Puhl, W
目的：膝关节和髋关节骨关节炎(GOA)在膝关节和髋关节骨关节炎患者中的不同发生率已有报道。本研究的目的是评估以医院为基础的晚期髋关节和膝关节骨性关节炎患者群体的X线和临床模式，并比较髋关节或膝关节骨性关节炎患者中GOA的患病率，同时考虑潜在的混杂因素。方法对4家医院420例髋关节骨性关节炎患者和389例膝关节骨性关节炎患者进行同侧和对侧髋关节或膝关节及双手的X线片分析，并进行标准化访谈和临床检查。根据对侧关节的放射学改变的严重程度(以Kellgren-Lawrence大于或等于2级作为病例定义)，参与者被分为单侧或双侧骨关节炎。如果存在手部两个关节组(第一腕掌关节和近/远端指间关节被定义为两个独立的关节组)的X线改变，则患者被归类为GOA。结果：髋部OA患者的平均年龄为60.4岁，女性(52.4%)的可能性低于膝关节OA患者(分别为66.3岁和72.5%)。两组患者入院时的疼痛和功能损害强度相似，而膝关节骨关节炎患者的症状持续时间(中位数为10年)长于髋部骨关节炎患者(5年)。在41.7%的髋关节骨性关节炎和33.4%的膝关节骨性关节炎患者中，可以观察到置换关节的潜在病理状态，这使得可以将其归类为继发性骨性关节炎。约82.1%的髋关节和87.4%的膝关节骨性关节炎患者的对侧关节有放射学改变(双侧病变)。GOA患病率随年龄增长而增加，女性患病率较高。膝关节骨性关节炎患者的GOA发生率高于髋部骨性关节炎患者(34.9%比19.3%；OR=2.24；95%CI：1.56，3.21)。然而，对两组患者不同的年龄和性别分布进行调整，消除了大部分差异(OR=1.32；95%CI：0.89，1.96)。结论-粗略的结果证实了先前的报道以及GOA在晚期膝骨性关节炎患者中比在晚期髋部骨性关节炎患者中更常见的临床印象。然而，这些不同的模式可能在很大程度上归因于这些以医院为基础的人群中不同的年龄和性别分布。
Objectives-Different prevalences of generalised osteoarthritis (GOA) in patients with knee and hip OA have been reported. The aim of this investigation was to evaluate radiographic and clinical patterns of disease in a hospital based population of patient subgroups with advanced hip and knee OA and to compare the prevalence of GOA in patients with hip or knee OA, taking potential confounding factors into account.Methods-420 patients with hip OA and 389 patients with knee OA scheduled for unilateral total joint replacement in four hospitals underwent radiographic analysis of ipsilateral and contralateral hip or knee joint and both hands in addition to a standardised interview and clinical examination. According to the severity of radiographic changes in the contralateral joints (using Kellgren-Lawrence greater than or equal to grade 2 as case definition) participants were classified as having either unilateral or bilateral OA. If radiographic changes of two joint groups of the hands (first carpometacarpal joint and proximal/distal interphalangeal joints defined as two separate joint groups) were present, patients were categorised as having GOA.Results-Patients with hip OA were younger (mean age 60.4 years) and less likely to be female (52.4%) than patients with knee OA (66.3 years and 72.5% respectively). Intensity of pain and functional impairment at hospital admission was similar in both groups, while patients with knee OA had a longer symptom duration (median 10 years) compared with patients with hip OA (5 years). In 41.7% of patients with hip OA and 33.4% of patients with knee OA an underlying pathological condition could be observed in the replaced joint, which allowed a classification as secondary OA. Some 82.1% of patients with hip and 87.4% of patients with knee OA had radiographic changes in their contralateral joints (bilateral disease). The prevalence of GOA increased with age and was higher in female patients. GOA was observed more often in patients with knee OA than in patients with hip OA (34.9% versus 19.3%; OR=2.24; 95% CI: 1.56, 3.21). Adjustment for the different age and sex distribution in both patient groups, however, takes away most of the difference (OR=1.32; 95% CI: 0.89, 1.96).Conclusion-The crude results confirm previous reports as well as the clinical impression of GOA being more prevalent in patients with advanced knee OA than in patients with advanced hip OA. However, these different patterns might be attributed to a large part to a different distribution of age and sex in these hospital based populations.