Independent association of joint space narrowing, cyst formation and health-related quality of life of patients with hip osteoarthritis in Japan

Factors associated with health-related quality of life in Japanese patients with hip osteoarthritis: A cross-sectional study

Background/Purpose:

Chronic symptoms related with hip osteoarthritis (OA) can negatively affect health-related quality of life (HRQoL). The purpose of this study was to examine factors related to a HRQoL measure that considers an Asian lifestyle in Japanese patients with hip OA.

Methods:

Forty-seven female subjects participated. The dependent variable was the Japanese Orthopaedic Association Hip Disease Evaluation Questionnaire (JHEQ), which assessed HRQoL. Potential factors were measured as independent variables. After screening, potential variables were entered into a multiple regression analysis to determine which variables were related to HRQoL.

Results:

In the regression model, knee extension muscle strength on the unaffected side and hip flexion range of motion (ROM) on the affected side were associated with HRQoL. Higher strength and higher ROM were related to greater HRQoL.

Conclusion:

Results can help health-care providers develop appropriate rehabilitation programs for improving HRQoL in patients with hip OA.

The relationship between radiographic findings and patient-reported outcomes in adult hip dysplasia patients: A hospital cross-sectional study

INTRODUCTION

This study aimed to clarify the relationship of individual radiographic parameters and features with the patient-reported outcome measurements (PROMs) of patients with developmental dysplasia of the hip (DDH) in a hospital-referred cross-sectional analysis.

METHODS

This cross-sectional study included 108 Japanese DDH patients (female, n = 88; male, n = 20; mean age, 43.4 years). We recorded the CE angle, angle of Sharp, ARO, ADR, AHI, crossover sign, pistol grip deformity, and femoral head-neck ratio, which were measured on the AP view, and the α-angle, which was measured on the Lauenstein view. We also recorded cyst formation and osteophytes on either view. We used the Japanese Orthopaedic Association hip disease evaluation questionnaire (JHEQ) to assess the PROMs. The PROMs of patients with and without cysts or osteophytes and those of patients with or without cam or pincer deformity were compared. The relationships between specific PROMs and radiographic features were evaluated with a linear regression analysis and independent associations between PROMs and radiographic features were assessed with a multiple regression analysis using various independent variables.

RESULTS

The JHEQ movement and mental values in patients with cyst formation were significantly lower in comparison to those in patients without cyst formation. The JHEQ subscale values did not differ according to the presence or absence of osteophytes, cam deformity or pincer deformity. The CE angle was found to be associated with the JHEQ movement score in the linear regression analysis. To identify radiographic features that were independently associated with each of the JHEQ subscale scores, we performed a multiple regression analysis with age, body mass index, sex and the number of affected hip joints (bilateral or unilateral) included as independent variables. The CE angle was found to be independently associated with JHEQ movement.

CONCLUSION

The CE angle was independently associated with the JHEQ movement value.

Clinical outcomes of patients with residual medial osteophytes following mobile bearing unicompartmental knee arthroplasty

Introduction

The surgical technique used in unicompartmental knee arthroplasty (UKA) is crucial for achieving good short and long term clinical outcomes. The medial mobile bearing UKA has shown excellent clinical outcomes and survivorship. But release of the medial collateral ligament during entering joint is cause of mobile bearing dislocation in short term outcomes and lateral compartment osteoarthritis may occur in the mid to long term outcomes. Removing all osteophytes at the time of UKA is sometime impossible due to their large size and extend to the inferior part of medial tibial plateau and removing them completely my result in release of the MCL. But no data exist on clinical outcomes in such patients.

Methods

We conducted a prospective study from 2010 to 2015 of patients undergoing mobile bearing UKA and classified them in to two groups: those with (Gp1) and without (Gp2) residual osteophytes. Osteophyte size was measured using Hernborg’s technique. The primary outcomes were pain score, functional score, and knee scores and the presence of reported medial knee pain.

Results

176 patients who underwent 199 mobile bearing UKAs were recruited: Gp1 = 42 patients (46 knees) and Gp2 = 134 patients (153 knees). Residual osteophyte sizes ranged from 2.13–9.42 mm (mean 4.12). The mean Gp1 Gp2 pain score (49.04, 48.92, p = 0.84), functional score (83.75, 84.04, p = 0.83) and knee score (89.86, 98.7, p = 0.0.78) scores were almost identical and no one complained of medial joint pain. Followed up ranged from 2 − 7 years (mean 4.23). No patients were lost to follow up.

Conclusion

The patients with residual osteophytes of length less than 9 mm had good and similar clinical outcomes as patients without residual osteophytes following mobile bearing UKA.

Level of evidence

Level II-2, evidence obtained from well-designed cohort studies or case-control studies, preferably from more than one center or research group.