背景:凸轮形态有助于髋关节骨关节炎(OA)的发展,但在一般人群中研究较少。这项研究描述了其与髋关节OA的临床和影像学特征的关联。
方法:塔斯马尼亚老年成年队列(TASOAC)的1019名参与者的髋部前后位X光片在基线时对两个髋部的α角(凸轮形态)进行评分。使用奥特曼的地图集,在基线时评估影像学髋关节OA(ROA).在5年时,在245张磁共振图像(MRI)的子集上评估了髋关节疼痛和右髋关节结构变化。全髋关节置换(THR)的关节登记数据从基线获得14年。
结果:在1906年的图像中,对1016例右髋和890例左髋的凸轮形态进行了评估.跨领域,凸轮形态与年龄(患病率比[PR]:1.02P=.03)和体重指数(BMI)(PR:1.03-1.07,P=.03)适度相关,与男性密切相关(PR:2.96,P<.001)。射线照相,凸轮形态在关节间隙减少(PR:1.30P=.03)和骨赘(PR:1.47,P=.03)的患者中普遍存在。纵向,右凸轮和高BMI的参与者有更多的髋部疼痛(PR:17.9,P=.02).在5年的随访结束时,这些参与者也更有可能发生结构变化,例如骨髓病变(BMLs)(PR:1.90P=.04),软骨缺损(PR:1.26,P=.04)和多个部位的渗出性滑膜炎(PR:1.25P=.02)。在14年结束时,任一髋关节的基线凸轮形态预测了THR的三倍风险(PR:3.19,P=.003)。
结论:在基线时,凸轮形态与年龄有关,重量更高,男性,影像学OA的早期征象,如关节间隙狭窄(JSN)和骨赘(OST)。在后续行动中,凸轮预测髋部BML的发展,髋部积液-滑膜炎,软骨损伤和THR。这些发现表明,凸轮形态在早期OA中起着重要作用,并且在以后的生活中可能是髋关节OA的前兆或促成。
BACKGROUND: Cam morphology contributes to the development of hip osteoarthritis (OA) but is less studied in the general population. This
study describes its associations with clinical and imaging features of hip OA.
METHODS: Anteroposterior hip radiographs of 1019 participants from the Tasmanian Older Adult Cohort (TASOAC) were scored at baseline for α angle (cam morphology) in both hips. Using the Altman\'s atlas, radiographic hip OA (ROA) was assessed at baseline. Hip pain and right hip structural changes were assessed on a subset of 245 magnetic resonance images (MRI) at 5 years. Joint registry data for total hip replacement (THR) was acquired 14 years from baseline.
RESULTS: Of 1906 images, cam morphology was assessed in 1016 right and 890 left hips. Cross-sectionally, cam morphology modestly associated with age (prevalence ratio [PR]: 1.02 P = .03) and body mass index (BMI) (PR: 1.03-1.07, P = .03) and strongly related to male gender (PR: 2.96, P < .001). Radiographically, cam morphology was prevalent in those with decreased joint space (PR: 1.30 P = .03) and osteophytes (PR: 1.47, P = .03). Longitudinally, participants with right cam and high BMI had more hip pain (PR: 17.9, P = .02). At the end of 5 years of follow-up these participants were also more likely to have structural changes such as bone marrow lesions (BMLs) (PR: 1.90 P = .04), cartilage defects (PR: 1.26, P = .04) and effusion-synovitis at multiple sites (PR: 1.25 P = .02). Cam morphology at baseline in either hip predicted up to threefold risk of THR (PR: 3.19, P = .003) at the end of 14 years.
CONCLUSIONS: At baseline, cam morphology was linked with age, higher weight, male gender, early signs of radiographic OA such as joint space narrowing (JSN) and osteophytes (OST). At follow-up, cam predicted development of hip BMLs, hip effusion-synovitis, cartilage damage and THR. These findings suggest that cam morphology plays a significant role in early OA and can be a precursor or contribute to hip OA in later life.