The progression of end-stage osteoarthritis: analysis of data from the Australian and Norwegian joint replacement registries using a multi-state model
The progression of end-stage osteoarthritis: analysis of data from the Australian and Norwegian joint replacement registries using a multi-state model
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DOI：
10.1016/j.joca.2012.12.008
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发表时间：
2013-03-01
影响因子：
7
通讯作者：
Ryan, P.
中科院分区：
文献类型：
--
作者：
Gillam, M. H.;Lie, S. A.;Ryan, P.
目的：关节置换的发生率被认为是症状性终末期骨关节炎（OA）的指标。我们分析了来自两个国家关节置换登记处的数据，以调查是否可以在来自大样本人群的数据中发现终末期髋关节和膝关节OA进展模式的证据。设计：我们从澳大利亚骨科协会国家关节置换登记处获得了78,634例髋关节和122,096例膝关节置换术的数据，挪威关节置换登记中心的082例膝关节置换术。开发了一个多状态模型，其中个体从首次记录的OA髋关节或膝关节置换术到随后接受髋关节和/或膝关节置换术进行随访。我们使用这个模型来估计相对危险率和概率分别为每个registration.Results：在非同源关节接受后续关节成形术的危险率是对侧高于同侧的指数关节成形术，特别是如果指数是髋关节成形术。5年后，估计的概率已收到对侧的指数髋关节的膝关节的概率已收到同侧的指数hipe.Conclusion：结果表明，有一个协会之间的第一次髋关节置换术和侧随后的膝关节置换术。需要进一步的研究来调查对侧膝关节接受关节成形术的风险增加是否与髋关节成形术和/或术前因素（如与髋关节OA相关的疼痛和步态改变）相关。Crown版权所有（C）2013由Elsevier Ltd代表国际骨关节炎研究学会发布。All rights reserved.
Objective: The incidence of joint replacements is considered an indicator of symptomatic end-stage osteoarthritis (OA). We analysed data from two national joint replacement registries in order to investigate whether evidence of a pattern of progression of end-stage hip and knee OA could be found in data from large unselected populations.Design: We obtained data on 78,634 hip and 122,096 knee arthroplasties from the Australian Orthopaedic Association National Joint Replacement Registry and 19,786 hip and 12,082 knee arthroplasties from the Norwegian Arthroplasty Register. A multi-state model was developed where individuals were followed from their first recorded hip or knee arthroplasty for OA to receiving subsequent hip and/or knee arthroplasties. We used this model to estimate relative hazard rates and probabilities for each registry separately.Results: The hazard rates of receiving subsequent arthroplasties in non-cognate joints were higher on the contralateral side than on the ipsilateral side to the index arthroplasty, especially if the index was a hip arthroplasty. After 5 years, the estimated probabilities of having received a knee contralateral to the index hip were more than 1.7 times the probabilities of having received a knee ipsilateral to the index hip.Conclusion: The results indicate that there is an association between the side of the first hip arthroplasty and side of subsequent knee arthroplasties. Further studies are needed to investigate whether increased risk of receiving an arthroplasty in the contralateral knee is related to having a hip arthroplasty and/or preoperative factors such as pain and altered gait associated with hip OA. Crown Copyright (C) 2013 Published by Elsevier Ltd on behalf of Osteoarthritis Research Society International. All rights reserved.