Abstract：
UNASSIGNED: It is unclear which factors are associated with a successful total hip arthroplasty (THA) in patients with early radiographic osteoarthritis (OA).
UNASSIGNED: 70 patients with early OA (Kellgren and Lawrence [KL] grades 0-2) who underwent THA were compared with 200 patients with advanced OA (KL grades 3-4). Outcomes were Oxford Hip Scores (OHS), EQ-5D and EQ-VAS scores; compared preoperatively with 1 year postoperatively. We investigated which clinical and radiographic (plain x-ray, CT, MRI) features predicted successful THA (postoperative OHS ⩾42).
UNASSIGNED: The early OA group were significantly younger (61 vs. 66 years; [p = 0.0035). There were no significant differences in BMI, ASA grade or gender. After adjusting for confounders, the advanced OA group had a significantly greater percentage of possible change (PoPC) in OHS (75.8% vs. 50.4%; p < 0.0001) and improvement in EQ-5D (0.151 vs. 0.002; p < 0.0001). There were no significant differences in complication, revision or readmission rates. In the early OA group, 16/70 (22.9%) patients had a \'successful\' THA. Patients who had a \'successful\' THA were significantly more likely to have subchondral cysts on CT/MRI (91.7% vs. 57.7%; p = 0.0362). The presence of cysts on CT/MRI was associated with a significantly greater PoPC in OHS (61.6% vs. 38.2%; p = 0.0353). The combination of cysts and joint space width <1 mm was associated with a PoPC of 68%.
UNASSIGNED: THA in patients with early OA (KL grades 0-2) on plain radiographs should be indicated with caution. We advocate preoperative cross-sectional imaging in these patients. In the absence of cysts on CT/MRI, a THA seems unlikely to provide a satisfactory outcome.
UNASSIGNED: 70 patients with early OA (Kellgren and Lawrence [KL] grades 0-2) who underwent THA were compared with 200 patients with advanced OA (KL grades 3-4). Outcomes were Oxford Hip Scores (OHS), EQ-5D and EQ-VAS scores; compared preoperatively with 1 year postoperatively. We investigated which clinical and radiographic (plain x-ray, CT, MRI) features predicted successful THA (postoperative OHS ⩾42).
UNASSIGNED: The early OA group were significantly younger (61 vs. 66 years; [p = 0.0035). There were no significant differences in BMI, ASA grade or gender. After adjusting for confounders, the advanced OA group had a significantly greater percentage of possible change (PoPC) in OHS (75.8% vs. 50.4%; p < 0.0001) and improvement in EQ-5D (0.151 vs. 0.002; p < 0.0001). There were no significant differences in complication, revision or readmission rates. In the early OA group, 16/70 (22.9%) patients had a \'successful\' THA. Patients who had a \'successful\' THA were significantly more likely to have subchondral cysts on CT/MRI (91.7% vs. 57.7%; p = 0.0362). The presence of cysts on CT/MRI was associated with a significantly greater PoPC in OHS (61.6% vs. 38.2%; p = 0.0353). The combination of cysts and joint space width <1 mm was associated with a PoPC of 68%.
UNASSIGNED: THA in patients with early OA (KL grades 0-2) on plain radiographs should be indicated with caution. We advocate preoperative cross-sectional imaging in these patients. In the absence of cysts on CT/MRI, a THA seems unlikely to provide a satisfactory outcome.
摘要：
■目前尚不清楚哪些因素与早期影像学骨关节炎（OA）患者的全髋关节置换术（THA）成功相关。
■将70例接受THA的早期OA患者（Kellgren和Lawrence[KL]0-2级）与200例晚期OA患者（KL3-4级）进行比较。结果是牛津髋关节得分（OHS），EQ-5D和EQ-VAS评分；比较术前与术后1年。我们调查了哪些临床和影像学(X线平片，CT,MRI）特征预测成功的THA（术后OHS442）。
■早期OA组明显年轻（61vs.66岁；[p=0.0035)。BMI没有显著差异,ASA等级或性别。在调整了混杂因素后，晚期OA组OHS的可能变化（PoPC）百分比明显更高（75.8％vs.50.4%；p<0.0001）和EQ-5D的改善（0.151vs.0.002;p<0.0001)。并发症无显著差异，修订或再接纳率。早期OA组,16/70（22.9%）患者的THA成功。THA成功的患者在CT/MRI上更有可能出现软骨下囊肿(91.7%vs.57.7%；p=0.0362）。CT/MRI上囊肿的存在与OHS中PoPC的显着增加相关（61.6％vs.38.2%；p=0.0353）。囊肿和关节间隙宽度<1mm的组合与68%的PoPC相关。
■在平片上早期OA（KL等级0-2）患者的THA应谨慎指示。我们提倡对这些患者进行术前横断面成像。在CT/MRI上没有囊肿的情况下，aTHA似乎不太可能提供令人满意的结果。
■将70例接受THA的早期OA患者（Kellgren和Lawrence[KL]0-2级）与200例晚期OA患者（KL3-4级）进行比较。结果是牛津髋关节得分（OHS），EQ-5D和EQ-VAS评分；比较术前与术后1年。我们调查了哪些临床和影像学(X线平片，CT,MRI）特征预测成功的THA（术后OHS442）。
■早期OA组明显年轻（61vs.66岁；[p=0.0035)。BMI没有显著差异,ASA等级或性别。在调整了混杂因素后，晚期OA组OHS的可能变化（PoPC）百分比明显更高（75.8％vs.50.4%；p<0.0001）和EQ-5D的改善（0.151vs.0.002;p<0.0001)。并发症无显著差异，修订或再接纳率。早期OA组,16/70（22.9%）患者的THA成功。THA成功的患者在CT/MRI上更有可能出现软骨下囊肿(91.7%vs.57.7%；p=0.0362）。CT/MRI上囊肿的存在与OHS中PoPC的显着增加相关（61.6％vs.38.2%；p=0.0353）。囊肿和关节间隙宽度<1mm的组合与68%的PoPC相关。
■在平片上早期OA（KL等级0-2）患者的THA应谨慎指示。我们提倡对这些患者进行术前横断面成像。在CT/MRI上没有囊肿的情况下，aTHA似乎不太可能提供令人满意的结果。
