Prevalence, incidence, and progression of hip osteoarthritis in a young military population: The ADVANCE cohort study

IF 2.8

Osteoarthritis and cartilage open Pub Date : 2025-09-02 DOI:10.1016/j.ocarto.2025.100675

F.C.E. Watson , O. O'Sullivan , A. Bennett , R. Agricola , S. Schofield , D. Hanff , C. Boos , P. Cullinan , N. Fear , H. Kemp , A.M.J. Bull

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Abstract

Objective

Prevalence of hip osteoarthritis (OA) is rarely reported in young populations (e.g., military). We will report the prevalence of hip OA in a young military cohort and investigate the relationship between injury and progression/incidence.

Design

ADVANCE is a prospective cohort study comparing physical and psychosocial outcomes in 1145 men who served in Afghanistan including 579 men with combat injury (Exposed) who were frequency-matched to 566 controls (Unexposed). The Exposed group was sub-divided into hip injured (Exp-H), lower limb amputation (Exp-A) and other (Exp-NA). Kellgren-Lawrence (KL) scores of pelvic radiographs and Non-Arthritic Hip Score (NAHS) questionnaires were collected across two waves (Baseline and Follow-up). Prevalence at Baseline (KL ≥ 2), progression (KL ≥ 1 at Baseline, KL ≥ 2 at Follow-up) and incidence (KL0 at Baseline, KL ≥ 2 at Follow-up) at Follow-up were reported and compared between groups for KL and NAHS.

Results

Baseline prevalence of radiographic hip OA was 8.5 % and 4.4 % in the Exposed and Unexposed groups, respectively. Exp-A and Exp-H groups had 3.88 (95%CI:2.27–6.63) and 7.18 (95%CI:3.44–14.98 times increased risk for radiographic hip OA than Unexposed. Exp-A and Exp-H had a 2.15 (95%CI:1.22–3.80) and 3.28 (95%CI:1.42–7.59) times increased radiographic progression risk, compared to Unexposed. Risk of NAHS Progression and Incidence were not significantly different between groups.

Conclusion

Radiographic hip OA prevalence is higher in a young military population than in a similarly aged general population. Combat injury alone may not increase hip OA prevalence; but hip and lower limb loss injuries do. Progression risk is highest in those with hip or limb loss injuries.

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年轻军人髋关节骨关节炎的患病率、发病率和进展：ADVANCE队列研究

目的髋关节骨关节炎（OA）的患病率在年轻人群（如军人）中很少报道。我们将报道一个年轻军人队列中髋关节骨关节炎的患病率，并调查损伤与进展/发病率之间的关系。DesignADVANCE是一项前瞻性队列研究，比较了在阿富汗服役的1145名男性的身体和心理社会结果，其中579名男性有战斗损伤（暴露），566名对照（未暴露）。暴露组又分为髋部损伤组（Exp-H）、下肢截肢组（Exp-A）和其他组（Exp-NA）。骨盆x线片Kellgren-Lawrence （KL）评分和非关节炎髋关节评分（NAHS）问卷分为基线和随访两组。报告基线时的患病率（KL≥2）、进展（基线时KL≥1，随访时KL≥2）和随访时的发病率（基线时KL0，随访时KL≥2），并比较KL和NAHS组之间的差异。结果暴露组和未暴露组髋关节骨性关节炎基线患病率分别为8.5%和4.4%。Exp-A组和Exp-H组髋关节骨性关节炎的风险分别是未暴露组的3.88倍（95%CI:2.27 ~ 6.63）和7.18倍（95%CI:3.44 ~ 14.98）。与未暴露组相比，Exp-A和Exp-H组的影像学进展风险分别增加2.15倍（95%CI: 1.22-3.80）和3.28倍（95%CI: 1.42-7.59）。两组间NAHS进展风险及发病率无显著差异。结论年轻军人髋部骨性关节炎的放射学患病率高于同龄普通人群。单纯的战斗损伤可能不会增加髋关节骨关节炎的患病率；但髋部和下肢的损伤会。进展风险最高的是髋关节或肢体损伤。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Osteoarthritis and cartilage open Orthopedics, Sports Medicine and Rehabilitation

CiteScore

3.30

自引率

0.00%

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