Hss JournalPub Date : 2023-10-24DOI: 10.1177/15563316231204616
Marc Meyer-Pries, Melika Hajymiri, Theodoros Lytras, Philip Manolopoulos, Dimitrios Ntourakis
{"title":"Arthroscopy-Assisted Open Reduction Internal Fixation Versus Conventional Open Reduction Internal Fixation in the Treatment of Ankle Fractures: A Systematic Review With Meta-Analysis","authors":"Marc Meyer-Pries, Melika Hajymiri, Theodoros Lytras, Philip Manolopoulos, Dimitrios Ntourakis","doi":"10.1177/15563316231204616","DOIUrl":"https://doi.org/10.1177/15563316231204616","url":null,"abstract":"Background: Arthroscopy can be used to assist the open reduction internal fixation (ORIF) approach in the treatment of acute ankle fractures. Arthroscopy can also help to assess the articular surface but is performed in only 1% of ankle fracture cases. Purpose: We aimed to investigate (1) whether arthroscopy-assisted ORIF (AORIF) would lead to improved postoperative functional outcomes compared to conventional ORIF and (2) whether differences in postoperative complication rates exist between these 2 techniques. Methods: A systematic review was performed; 2 researchers independently searched the online databases of PubMed, Scopus, Embase, Cochrane, and Google Scholar. All studies that directly investigated the outcomes of AORIF versus conventional ORIF in the treatment of ankle fractures and contained quantitative data were eligible for inclusion. The Cochrane tools for bias assessment were applied independently by 2 researchers. Results: Six articles (2 randomized controlled trials and 4 retrospective cohort studies) were included in this systematic review. The meta-analysis of functional outcome scores resulted in a standardized mean difference of 0.6 (confidence interval [CI]: [0.3, 0.9]) favoring AORIF, after excluding 2 studies due to missing standard deviations. The overall complication rate was similar between the 2 groups, with a pooled odds ratio of 1.1 (CI: [0.4, 3.0]). Conclusion: The findings of this systematic review and meta-analysis suggest that AORIF might improve postoperative outcomes without increasing the complication rate when compared to conventional ORIF. However, due to the inherent clinical heterogeneity of the included studies, further well-designed randomized controlled trials are required.","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":"64 8","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135315695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hss JournalPub Date : 2023-10-23DOI: 10.1177/15563316231201126
Chengcheng Zhao, Qiuru Wang, Lijun Cai, Liyile Chen, Pengde Kang
{"title":"Adductor Canal Block Combined With IPACK Block for Postoperative Analgesia After Total Knee Arthroplasty: A Retrospective Cohort Study","authors":"Chengcheng Zhao, Qiuru Wang, Lijun Cai, Liyile Chen, Pengde Kang","doi":"10.1177/15563316231201126","DOIUrl":"https://doi.org/10.1177/15563316231201126","url":null,"abstract":"Background: There is no consensus on whether adductor canal block (ACB) combined with infiltration between the popliteal artery and capsule of the posterior knee (IPACK) block can further increase analgesia and reduce opioid consumption after total knee arthroplasty (TKA) compared with ACB and periarticular infiltration analgesia (PIA). Purpose: This study aimed to evaluate the effectiveness of combining ACB and PACK block on analgesia and functional recovery following TKA. Methods: A retrospective cohort study was conducted involving 386 patients who underwent primary unilateral TKA at our institution from January 2020 to October 2022. Patients were divided into 3 groups and treated with PIA, ACB, or ACB combined with IPACK block, respectively. Primary outcomes were postoperative morphine consumption and visual analogue scale (VAS) pain scores. Secondary outcomes included functional recovery, evaluated by knee range of motion, quadriceps strength, daily mobilization distance, and postoperative length of stay. Other outcomes included incidence of complications. Results: Patients in the ACB + IPACK group had significantly less morphine consumption on postoperative day 1 and during hospitalization than patients in the PIA and ACB groups. Furthermore, the ACB + IPACK group had significantly lower VAS scores at rest and during motion at 6, 12, and 24 hours postoperatively (but not at other time points), better knee range of motion on postoperative days 1 and 2 (but not day 3), and a greater daily mobilization distance on postoperative day 1 (but not days 2 and 3). The ACB + IPACK group had significantly lower incidences of postoperative nausea and vomiting than the PIA and ACB groups. Conclusion: This retrospective cohort study suggests that a combination of ACB and IPACK block may have a greater effect than PIA or ACB alone on analgesia following TKA, while providing better functional recovery. Further study is warranted.","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135412879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hss JournalPub Date : 2023-10-11DOI: 10.1177/15563316231199493
Samuel S. Rudisill, Alexander L. Hornung, Nathan H. Varady, Christian A. Pean, Joseph M. Lane, Troy B. Amen
{"title":"Racial and Ethnic Disparities in Hip Fracture Surgery: A Systematic Review and Meta-Analysis","authors":"Samuel S. Rudisill, Alexander L. Hornung, Nathan H. Varady, Christian A. Pean, Joseph M. Lane, Troy B. Amen","doi":"10.1177/15563316231199493","DOIUrl":"https://doi.org/10.1177/15563316231199493","url":null,"abstract":"Background: Hip fractures are common injuries that result in substantial loss of quality of life to elderly patients. To date, no meta-analyses have been performed to consolidate findings related to racial and ethnic disparities in hip fracture care. Purpose: We sought to examine associations between racial or ethnic identity and several metrics of hip fracture care. Methods: For a systematic review and meta-analysis, we searched PubMed, Scopus, CINAHL, and SPORTDiscus databases in December 2021 for articles examining racial and ethnic disparities in hip fracture surgery among White, Black, Hispanic, Asian, Pacific Islander (PI), and American Indian/Alaska Native (AIAN) patients. Twenty-three studies reported time to surgery (TTS), complications, mortality, length of stay (LOS), discharge disposition, readmissions, or reoperations. Meta-analyses were conducted for outcomes for which there were at least 3 comparable studies with requisite data available. Results: Compared with White patients, Black patients experienced greater rates of TTS longer than 2 days, 30-day complication, 90-day readmission, 1-year reoperation, and longer LOS, though odds of 30-day mortality were reduced. Hispanic patients had higher 90-day complication rates and longer LOS but lower risk of mortality and nonhome discharge than other racial and ethnic groups. Time to surgery of longer than 2 days was more common among Asian patients, though mortality, nonhome discharge, and readmission rates were lower. There were higher mortality rates in White patients compared with Hispanic patients at all timepoints and compared with Black patients until 1 year following surgery, when rates were higher among Black patients. Conclusions: This systematic review and meta-analysis found evidence of disparities in hip fracture surgery, with minority patients facing greater rates of surgical delay and perioperative complications. Even though the studies may not have been uniform in defining race or ethnicity or in accounting for the effects of systemic racism, these findings suggest that concerted efforts are needed to understand these gaps and promote equity in hip fracture care.","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136212320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hss JournalPub Date : 2023-09-28DOI: 10.1177/15563316231201335
David H. Kim, Genewoo Hong, Edward Lin, Sang Jo Kim, Jonathan Beathe, Douglas Wetmore, Jiabin Liu
{"title":"Combined Pericapsular Nerve Group Block and Intrapelvic Lateral Femoral Cutaneous Nerve Block Is Associated With Decreased Opioid Consumption After Hip Arthroscopy: A Retrospective Cohort Study","authors":"David H. Kim, Genewoo Hong, Edward Lin, Sang Jo Kim, Jonathan Beathe, Douglas Wetmore, Jiabin Liu","doi":"10.1177/15563316231201335","DOIUrl":"https://doi.org/10.1177/15563316231201335","url":null,"abstract":"Introduction: Ambulatory hip arthroscopies are associated with moderate-to-severe pain often requiring opioid analgesia. Novel motor-sparing blocks, the pericapsular nerve group (PENG) and lateral femoral cutaneous nerve (LFCN) block, have shown efficacy in hip surgery. Purpose: We sought to investigate the analgesic benefits of these novel blocks in terms of opioid-sparing and discharge efficiency. Methods: We conducted a retrospective cohort study with propensity score matching of 224 patients who underwent ambulatory elective unilateral hip arthroscopy. One group received a combined PENG and LFCN block (PENG/LFCN, n = 86), while a second group received only a PENG block (n = 26). A control group (n = 112) received no blocks. The primary outcome was postanesthesia care unit (PACU) mean opioid consumption. Secondary outcomes were maximum numeric rating scale (NRS) pain score, intravenous rescue analgesia, and PACU readiness-for-discharge times. Results: The PENG/LFCN-block group required significantly less opioids than the control group in the PACU (25.98 ± 13.04 vs 14.58 ± 5.77, respectively) and were discharged earlier 2.72 ± 1.16 vs 4.42 ± 1.63 hours, respectively). The combined PENG/LFCN group also used less intravenous rescue opioids than the control group (0.47 ± 1.18 vs 1.44 ± 2.1 mg, respectively) and showed a significant difference in the highest NRS pain scores than the control group (6.01 ± 2.38 vs 6.77 ± 2.1 respectively). The PENG block alone group did not show a significant difference in opioid reduction (21.95 ± 15.83 vs 27.72 ± 15.01, respectively). Conclusions: This retrospective study found that in patients who underwent ambulatory elective unilateral hip arthroscopy, a combined PENG and LFCN block was associated with expedited PACU discharge and a clinically significant reduction in postoperative opioid use. Further study is warranted.","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135426142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hss JournalPub Date : 2023-09-26DOI: 10.1177/15563316231200496
Varag Abed, Cale Jacobs, Matthew Skinner, Mitchell Owens, Dro Keshishi, Austin V. Stone
{"title":"How Well Do Studies of Mesenchymal Stem Cell Intervention and Knee Osteoarthritis Adhere to the Minimum Information for Studies Evaluating Biologics Guidelines? A Systematic Review of Randomized Controlled Trials","authors":"Varag Abed, Cale Jacobs, Matthew Skinner, Mitchell Owens, Dro Keshishi, Austin V. Stone","doi":"10.1177/15563316231200496","DOIUrl":"https://doi.org/10.1177/15563316231200496","url":null,"abstract":"Background: The Minimum Information for Studies Evaluating Biologics in Orthopaedics (MIBO) guidelines for mesenchymal stem cell (MSC) research, published in 2017, contain a suggested checklist for reporting items in manuscripts involving MSCs. Purpose: We sought to determine how well randomized controlled trials (RCTs) on MSC intervention for knee osteoarthritis (OA) adhered to the MIBO guidelines. Methods: A comprehensive literature search was performed in the PubMed/MEDLINE and Web of Science databases. Inclusion criteria included English-only RCTs that assessed MSC intervention for knee OA published between 2018 and 2022. Metrics were extracted, including year of publication, study design, first author name, journal name, patient demographics, and MIBO checklist criteria. Results: In 27 RCTs analyzed, 1006 patients were included, with a weighted male percentage of 41.8% and weighted mean age of 60.5 ± 7.2 years. On average, 70.5% (range, 30.2%–90.6%) of the modified 53-point MIBO checklist elements were reported per article. Seven (25.9%) articles had adherence rates of 80% or more, 13 (48.1%) had rates between 60% and 79.9%, and 7 (25.9%) had rates of 59.9% or less. The MIBO “intervention” category had the greatest adherence (100%), while the other categories had more variability. Six (50.0%) categories had an adherence level of 80% or more, 3 (25.0%) had adherence levels of 60% to 79.9%, and 3 (25.0%) had an adherence level of 59.9% or less. Conclusion: The overall mean adherence to MIBO guidelines of RCTs on MSC intervention for knee OA was 70.5%. Authors should better integrate the MIBO guidelines into their methodology to improve transparency, reproducibility, and reporting.","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134957955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hss JournalPub Date : 2023-09-26DOI: 10.1177/15563316231201410
Erika L. Cyphert, Shannon Clare, Alexander Dash, Jacob C. Nixon, Joseph Raphael, Jonathan Harrison, Alison Heilbronner, Han Jo Kim, Matthew Cunningham, Darren Lebl, Frank Schwab, Christopher J. Hernandez, Emily M. Stein
{"title":"A Pilot Study of the Gut Microbiota in Spine Fusion Surgery Patients","authors":"Erika L. Cyphert, Shannon Clare, Alexander Dash, Jacob C. Nixon, Joseph Raphael, Jonathan Harrison, Alison Heilbronner, Han Jo Kim, Matthew Cunningham, Darren Lebl, Frank Schwab, Christopher J. Hernandez, Emily M. Stein","doi":"10.1177/15563316231201410","DOIUrl":"https://doi.org/10.1177/15563316231201410","url":null,"abstract":"Background: The microbiome has been identified as a contributor to bone quality. As skeletal health is critical to success of orthopedic surgery, the gut microbiome may be a modifiable factor associated with postoperative outcomes. For spine fusion surgery in particular, de novo bone formation and sufficient bone mineral density are essential for successful outcomes. Given the prevalence and complexity of these procedures, the identification of novel factors that may be related to operative success is important. Questions/purposes: We sought to investigate how the composition of the microbiota related to bone health in a focused spinal fusion surgery cohort. Methods: We investigated the composition of the microbiome in a cohort of 31 patients prior to spinal fusion surgery, as well as changes in the microbiome over 6 weeks postoperatively. Preoperative areal bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry. Results: Composition of gut microbiota differed among spinal fusion patients with low bone mass ( T-score ≤ −1.0) and those with normal BMD ( P = .03). There was no significant change in composition of the gut microbiota between preoperative evaluation and 6 weeks postoperatively. Conclusions: Our findings in this small sample suggest there may be a relationship between BMD and composition of the gut microbiome in patients who undergo spinal fusion surgery. Further work is needed to investigate these relationships as well as potential interventions to foster a favorable microbial composition in spinal fusion surgery patients.","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134957844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Osteolytic Schwannoma in an Older Patient With Lumbar Degenerative Disk Disease: A Case Report","authors":"Changjun Chen, Qingwei Ma, Yubin Qi, Yingguang Wu, Jingkun Li, Yanjun Ren, Yun Yang","doi":"10.1177/15563316231200862","DOIUrl":"https://doi.org/10.1177/15563316231200862","url":null,"abstract":"","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135817517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hss JournalPub Date : 2023-09-12DOI: 10.1177/15563316231195299
Adam M. Gordon, Bhavya K. Sheth, Charles A. Conway, Andrew R. Horn, Ramin Sadeghpour, Jack Choueka
{"title":"Neighborhood Deprivation and Association With Medical Complications, Emergency Department Use, and Readmissions in Shoulder Arthroplasty Patients","authors":"Adam M. Gordon, Bhavya K. Sheth, Charles A. Conway, Andrew R. Horn, Ramin Sadeghpour, Jack Choueka","doi":"10.1177/15563316231195299","DOIUrl":"https://doi.org/10.1177/15563316231195299","url":null,"abstract":"Background: Social determinants of health are prognostic indicators for patients undergoing orthopedic procedures. Purpose: Using the area deprivation index (ADI), a validated, weighted index of material deprivation and poverty (a 0%-to-100% scale, with higher percentages indicating greater disadvantage), we sought to evaluate whether there are associations in shoulder arthroplasty patients between higher ADI and rates of (1) medical complications, (2) emergency department (ED) utilizations, (3) readmissions, and (4) costs. Methods: We queried the PearlDiver nationwide database for patients who had undergone primary shoulder arthroplasty from 2010 to 2020. Patients from regions associated with high ADI (95%+) were 1:1 propensity matched to a comparison group by age, sex, and Elixhauser Comorbidity Index. This yielded 49,440 patients in total. Outcomes included 90-day complications, ED utilizations, readmissions, and costs. Logistic regression models computed odds ratios (ORs) of ADI on the dependent variables. P values of < .05 were significant. Results: Patients from high ADI regions showed higher rates and odds of complications than those in the comparison group (10.84% vs 9.45%; OR: 1.10), including acute kidney injuries (1.73% vs 1.38%; OR: 1.23), urinary tract infections (3.19% vs 2.80%; OR: 1.13), and respiratory failures (0.49% vs 0.33%; OR: 1.44), but not increased ED visits (2.66% vs 2.71%; OR: 0.99) or readmissions (3.07% vs 2.96%; OR: 1.03). Patients from high ADI regions incurred higher costs on day of surgery ($8251 vs $7337) and at 90 days ($10,999 vs $9752). Conclusions: This 10-year retrospective database study found that patients from high ADI regions undergoing primary shoulder arthroplasty had increased rates of all 90-day medical complications, suggesting that measures of social determinants of health could inform health care policy and improve post-discharge care in these patients.","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135878225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hss JournalPub Date : 2023-09-12DOI: 10.1177/15563316231194614
Brian J. Like, Ellen M. Soffin, Sarah Ortolan, Carrie R. Guheen, Elaine Yang, Darryl B. Sneag, Vladimir N. Kramskiy, Anil S. Ranawat, James D. Beckman
{"title":"Incidence and Etiology of Rare Saphenous Nerve Injury After Knee Surgery with Adductor Canal Block: A Retrospective Observational Study","authors":"Brian J. Like, Ellen M. Soffin, Sarah Ortolan, Carrie R. Guheen, Elaine Yang, Darryl B. Sneag, Vladimir N. Kramskiy, Anil S. Ranawat, James D. Beckman","doi":"10.1177/15563316231194614","DOIUrl":"https://doi.org/10.1177/15563316231194614","url":null,"abstract":"Adductor canal block (ACB) is commonly included in multimodal analgesia regimens for knee surgery. Nonetheless, the incidence, etiology, and procedure-specific risk of saphenous nerve injury after knee surgery with ACB have not been established. We sought to identify the risk of saphenous nerve injury during knee surgery with ACB. We conducted a retrospective cohort study of patients at a single institution who underwent elective knee surgery with ultrasound-guided ACB between January 1, 2014, and December 31, 2018, and had subsequent saphenous nerve injury. The primary outcome was the incidence of saphenous nerve injury within 3 months of surgery, by surgical type and approach. Secondary outcomes included attribution of the most likely etiology and clinical outcome of the injury. In 28,196 cases of knee surgery with ACB, we identified 18 cases (0.06%) of saphenous nerve injury. The most common surgery associated with saphenous nerve injury was anterior cruciate ligament (ACL) reconstruction with autograft (8/18 cases); 3 cases of injury were seen after TKA, 2 after medial patellofemoral ligament reconstruction, 2 after arthroscopy/meniscal surgery, and 1 after patellar fixation. The most likely etiology of nerve injury was attributed to ACB in 5 of 18 cases (28%) and to non-ACB cause in 13 of 18 (72%). Prognosis was rated as unknown in 11 of 18, poor in 2 of 18, favorable in 3 of 18, and full recovery in 2 of 18. This 5-year retrospective, single-institution cohort study found a low overall incidence of saphenous nerve injury after knee surgery with ACB, but the injury likelihood varied based on surgery and approach. Although not statistically significant, ACL reconstruction with hamstring autograft and ACB performed for postoperative rescue analgesia were most frequently associated with nerve injury.","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":"134 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135878774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hss JournalPub Date : 2023-08-29DOI: 10.1177/15563316231192461
J. Runhaar, A. C. van Berkel, R. Agricola, J. V. van Meurs, S. Bierma-Zeinstra
{"title":"Risk Factors and Population-Attributable Fractions for Incident Hip Osteoarthritis","authors":"J. Runhaar, A. C. van Berkel, R. Agricola, J. V. van Meurs, S. Bierma-Zeinstra","doi":"10.1177/15563316231192461","DOIUrl":"https://doi.org/10.1177/15563316231192461","url":null,"abstract":"Background: Despite the huge burden of hip osteoarthritis (OA) and the lack of effective treatment, research into the primary prevention of hip OA is in its infancy. Purpose: We sought to evaluate risk factors for incident clinical and incident radiographic hip OA among middle-aged and older adults, to evaluate the importance of risk factors from a preventive perspective, and to estimate the percentage of new cases attributable to these risk factors. Methods: We retrospectively reviewed data from the Rotterdam study, an open-population cohort study of individuals aged 55 years or older. Data including baseline age, sex, body mass index, smoking status, education level, diagnosis of diabetes, C-reactive protein (CRP), cam morphology, acetabular dysplasia, radiographic thumb OA, radiographic hip OA, and hip pain were assessed for their association with incident clinical hip OA and incident radiographic hip OA separately, after 11 years of follow-up. The population-attributable fractions (PAFs) of statistically significant modifiable risk factors were calculated, as well. Results: New onset of clinical hip OA was seen in 19.9% (544 of 2729) and incident radiographic hip OA in 9.9% (329 of 3309). Female sex, education level below average (PAF 21.4%), and radiographic hip OA (PAF 3.4%) were statistically significantly associated with incident clinical hip OA. Female sex, age, overweight (PAF 20.0%), cam morphology (PAF 7.9%), acetabular dysplasia (PAF 3.6%), and radiographic thumb OA (PAF 4.7%) were statistically significantly associated with radiographic hip OA. Conclusions: Our retrospective analysis suggests that, from a primary prevention perspective, the most important modifiable risk factors among middle-aged and older individuals may be low educational level for incident clinical hip OA and overweight for incident radiographic hip OA. Further study is warranted.","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":"85 1","pages":"407 - 412"},"PeriodicalIF":2.5,"publicationDate":"2023-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88102528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}