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Observational Study
. 2017 Oct;20(10):1350-1360.
doi: 10.1111/1756-185X.13083. Epub 2017 May 10.

Differences in presentation, progression and rates of arthroplasty between hip and knee osteoarthritis: Observations from an osteoarthritis cohort study-a clear role for conservative management

Chamila Dabare  1 , Kim Le Marshall  1 , Albert Leung  1   2 , Carolyn J Page  3 , Peter F Choong  2   4 , Keith K Lim  1   2   5
Affiliations
Observational Study

Differences in presentation, progression and rates of arthroplasty between hip and knee osteoarthritis: Observations from an osteoarthritis cohort study-a clear role for conservative management

Chamila Dabare et al. Int J Rheum Dis. 2017 Oct.

Abstract

Aim: To describe the natural progression and the rates of arthroplasty of a cohort of hip and knee osteoarthritis (OA) patients.

Methods: An observational study of 247 consecutive patients who attended an OA clinic between May 2008 and August 2009. Follow-up survey was conducted from July 2014 to December 2014, with the primary end point being joint replacement surgery.

Results: One hundred and sixty-seven patients had knee OA and 80 patients had hip OA. When adjusted for other variables (age, gender, body mass index, Kellgren-Lawrence stage, symptom duration, presence of OA elsewhere and pain score), patients with hip OA demonstrated 86% increased hazard of surgery compared to knee OA patients (95% CI increase of 19% to 193%). At 6 years after initial consultation, 67% of patients with knee OA did not require a knee replacement surgery, while 40% (30, 51) of hip OA patients did not undergo surgery (95% CI: 59-74%). Overall at 6 years, 58% of patients (95% CI: 51-64%) did not undergo joint replacement surgery.

Conclusion: Knee and hip OA patients appear to behave differently, with hip OA patients more likely to undergo arthroplasty. There is a significant number of both hip OA and knee OA patients who did not require arthroplasty at the end of 6 years, suggesting a major role for conservative therapy.

Keywords: arthroplasty; hip; knee; osteoarthritis.

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Figures

Figure 1
Figure 1
Kaplan–Meier estimate of time to joint replacement surgery with 95% confidence intervals for overall cohort.
Figure 2
Figure 2
Kaplan–Meier estimate of time to joint replacement surgery with 95% confidence intervals stratified by joint involvement. formula image, 95% CI; formula image, Knee joint; formula image, 95% CI; formula image, Hip joint.
Figure 3
Figure 3
Kaplan–Meier estimate of time to joint replacement surgery with 95% confidence intervals stratified by Kellgren–Lawrence (K/L) grading scale. formula image, 95% CI; formula image, Stage 1/2; formula image, 95% CI; formula image, Stage 3; formula image, 95% CI; formula image, Stage 4.
Figure 4
Figure 4
Remaining patients without arthroplasty. formula image, Knee = 162; formula image, Hips = 78.
See this image and copyright information in PMC

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