Abstract：
OBJECTIVE: The objective is to determine the association and absolute risk of femoroacetabular impingement syndrome (FAIS) for the development of radiographic hip osteoarthritis (RHOA).
METHODS: This is a nationwide, multicentre prospective cohort study (Cohort Hip and Cohort Knee) with 1002 individuals aged between 45 and 65 years. Hips without definitive RHOA (Kellgren-Lawrence (KL) grade≤1) at baseline and with anteroposterior pelvic radiographs at baseline and 10-year follow-up available (n=1386 hips) were included. FAIS was defined by the baseline presence of a painful hip, limited internal hip rotation≤25° and cam morphology defined by an alpha angle>60°. The outcomes were incident RHOA (KL grade≥2 or total hip replacement (THR)) and incident end-stage RHOA (KL≥3 or THR) within 10 years.
RESULTS: Of the 1386 included hips (80% women; mean age 55.7±5.2 years), 21 hips fulfilled criteria for FAIS and 563 hips did not fulfil any of the FAIS criteria (reference group; no symptoms, no signs, no cam morphology). Within 10-year follow-up, 221 hips (38%) developed incident RHOA and 15 hips (3%) developed end-stage RHOA (including 9 hips with THR). Adjusted for sex, age and body mass index, FAIS with cam morphology resulted in an OR of 6.85 (95% CI 2.10 to 22.35) for incident RHOA and 47.82 (95% CI 12.51 to 182.76) for incident end-stage RHOA, compared with hips not having any FAIS criteria. The absolute risk of FAIS was 81% for incident RHOA and 33% for incident end-stage RHOA.
CONCLUSIONS: FAIS was strongly associated with the development of RHOA within 10 years. Although the baseline prevalence of FAIS was low, the high absolute risk of FAIS for RHOA warrants further studies to determine preventive strategies.
METHODS: This is a nationwide, multicentre prospective cohort study (Cohort Hip and Cohort Knee) with 1002 individuals aged between 45 and 65 years. Hips without definitive RHOA (Kellgren-Lawrence (KL) grade≤1) at baseline and with anteroposterior pelvic radiographs at baseline and 10-year follow-up available (n=1386 hips) were included. FAIS was defined by the baseline presence of a painful hip, limited internal hip rotation≤25° and cam morphology defined by an alpha angle>60°. The outcomes were incident RHOA (KL grade≥2 or total hip replacement (THR)) and incident end-stage RHOA (KL≥3 or THR) within 10 years.
RESULTS: Of the 1386 included hips (80% women; mean age 55.7±5.2 years), 21 hips fulfilled criteria for FAIS and 563 hips did not fulfil any of the FAIS criteria (reference group; no symptoms, no signs, no cam morphology). Within 10-year follow-up, 221 hips (38%) developed incident RHOA and 15 hips (3%) developed end-stage RHOA (including 9 hips with THR). Adjusted for sex, age and body mass index, FAIS with cam morphology resulted in an OR of 6.85 (95% CI 2.10 to 22.35) for incident RHOA and 47.82 (95% CI 12.51 to 182.76) for incident end-stage RHOA, compared with hips not having any FAIS criteria. The absolute risk of FAIS was 81% for incident RHOA and 33% for incident end-stage RHOA.
CONCLUSIONS: FAIS was strongly associated with the development of RHOA within 10 years. Although the baseline prevalence of FAIS was low, the high absolute risk of FAIS for RHOA warrants further studies to determine preventive strategies.
摘要：
目的：目的是确定股骨髋臼撞击综合征（FAIS）与放射学髋关节骨关节炎（RHOA）发展的相关性和绝对风险。
方法：这是一个全国性的，多中心前瞻性队列研究（队列髋关节和队列膝关节），对1002名年龄在45至65岁之间的个体进行。包括基线无明确RHOA（Kellgren-Lawrence（KL）≤1级）的髋关节以及基线和10年随访（n=1386髋）的前后骨盆X光片。FAIS是由髋关节疼痛的基线存在定义的，有限的髋部内部旋转≤25°，凸轮形态由α角>60°定义。结果为10年内的事件RHOA（KL≥2级或全髋关节置换（THR））和事件终末期RHOA（KL≥3或THR）。
结果：在1386例中包括臀部（80％的女性；平均年龄55.7±5.2岁），21髋符合FAIS标准，563髋不符合任何FAIS标准(参照组；无症状，没有迹象,无凸轮形态)。在10年的随访中，221个臀部（38％）发展为RHOA，15个臀部（3％）发展为终末期RHOA（包括9个臀部的THR）。根据性别调整，年龄和体重指数，具有凸轮形态的FAIS导致事件RHOA的OR为6.85（95％CI2.10至22.35），事件末期RHOA的OR为47.82（95％CI12.51至182.76），与没有任何FAIS标准的臀部相比。事件RHOA的FAIS绝对风险为81%，事件终末期RHOA为33%。
结论：FAIS与10年内RHOA的发展密切相关。尽管FAIS的基线患病率较低，RHOA的FAIS绝对风险较高,值得进一步研究以确定预防策略.
方法：这是一个全国性的，多中心前瞻性队列研究（队列髋关节和队列膝关节），对1002名年龄在45至65岁之间的个体进行。包括基线无明确RHOA（Kellgren-Lawrence（KL）≤1级）的髋关节以及基线和10年随访（n=1386髋）的前后骨盆X光片。FAIS是由髋关节疼痛的基线存在定义的，有限的髋部内部旋转≤25°，凸轮形态由α角>60°定义。结果为10年内的事件RHOA（KL≥2级或全髋关节置换（THR））和事件终末期RHOA（KL≥3或THR）。
结果：在1386例中包括臀部（80％的女性；平均年龄55.7±5.2岁），21髋符合FAIS标准，563髋不符合任何FAIS标准(参照组；无症状，没有迹象,无凸轮形态)。在10年的随访中，221个臀部（38％）发展为RHOA，15个臀部（3％）发展为终末期RHOA（包括9个臀部的THR）。根据性别调整，年龄和体重指数，具有凸轮形态的FAIS导致事件RHOA的OR为6.85（95％CI2.10至22.35），事件末期RHOA的OR为47.82（95％CI12.51至182.76），与没有任何FAIS标准的臀部相比。事件RHOA的FAIS绝对风险为81%，事件终末期RHOA为33%。
结论：FAIS与10年内RHOA的发展密切相关。尽管FAIS的基线患病率较低，RHOA的FAIS绝对风险较高,值得进一步研究以确定预防策略.
