Involvement of different risk factors in clinically severe large joint osteoarthritis according to the presence of hand interphalangeal nodes.
OBJECTIVE: To quantify the differences in risk factors influencing total hip replacement (THR) and total knee replacement (TKR) based on the presence versus absence of multiple interphalangeal nodes in 2 or more rays of the fingers of each hand in patients with large joint osteoarthritis (OA). METHO...
المؤلفون الرئيسيون: | , , , , , , , , , |
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التنسيق: | Journal article |
اللغة: | English |
منشور في: |
2010
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_version_ | 1826293525809987584 |
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author | Valdes, A McWilliams, D Arden, N Doherty, SA Wheeler, M Muir, K Zhang, W Cooper, C Maciewicz, R Doherty, M |
author_facet | Valdes, A McWilliams, D Arden, N Doherty, SA Wheeler, M Muir, K Zhang, W Cooper, C Maciewicz, R Doherty, M |
author_sort | Valdes, A |
collection | OXFORD |
description | OBJECTIVE: To quantify the differences in risk factors influencing total hip replacement (THR) and total knee replacement (TKR) based on the presence versus absence of multiple interphalangeal nodes in 2 or more rays of the fingers of each hand in patients with large joint osteoarthritis (OA). METHODS: A group of 3,800 patients with large joint OA who underwent total joint replacement (1,201 of whom had the nodal phenotype) and 1,906 control subjects from 2 case-control studies and a population-based cohort in the UK were studied. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated for the risk of total joint replacement in association with age, sex, body mass index (BMI), height, and prevalence of the T allele in the GDF5 rs143383 polymorphism. ORs for total joint replacement were compared between cases of nodal OA and cases of non-nodal OA and between patients who underwent TKR and those who underwent THR. RESULTS: Age, sex, and BMI had significantly higher ORs for an association with total joint replacement in nodal OA cases than in non-nodal OA cases. The GDF5 polymorphism was significantly associated with THR in cases of nodal OA, but not in cases of non-nodal OA, and increased height was a risk factor for THR in non-nodal OA cases only. Female sex was a protective risk factor for TKR in non-nodal OA cases (OR 0.60, 95% CI 0.52-0.70) but was predisposing for TKR in the nodal form of OA (OR 1.83, 95% CI 1.49-2.26). The nodal phenotype was associated with a significantly higher risk of undergoing both THR and TKR (OR 1.46, 95% CI 1.09-1.94) and also a significantly higher risk of bilateral TKR (OR 1.70, 95% CI 1.37-2.11), but, paradoxically, was associated with a lower risk of bilateral THR (OR 0.72, 95% CI 0.56-0.91). CONCLUSION: Nodal and non-nodal forms of large joint OA have significantly different risk factors and outcomes, indicating a different etiology for the 2 forms of OA. With regard to the likelihood of undergoing THR, this appears to be, at least in part, genetically determined. |
first_indexed | 2024-03-07T03:31:28Z |
format | Journal article |
id | oxford-uuid:bae0a985-cf2e-4e9c-9005-b2922a85e9e8 |
institution | University of Oxford |
language | English |
last_indexed | 2024-03-07T03:31:28Z |
publishDate | 2010 |
record_format | dspace |
spelling | oxford-uuid:bae0a985-cf2e-4e9c-9005-b2922a85e9e82022-03-27T05:12:49ZInvolvement of different risk factors in clinically severe large joint osteoarthritis according to the presence of hand interphalangeal nodes.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:bae0a985-cf2e-4e9c-9005-b2922a85e9e8EnglishSymplectic Elements at Oxford2010Valdes, AMcWilliams, DArden, NDoherty, SAWheeler, MMuir, KZhang, WCooper, CMaciewicz, RDoherty, MOBJECTIVE: To quantify the differences in risk factors influencing total hip replacement (THR) and total knee replacement (TKR) based on the presence versus absence of multiple interphalangeal nodes in 2 or more rays of the fingers of each hand in patients with large joint osteoarthritis (OA). METHODS: A group of 3,800 patients with large joint OA who underwent total joint replacement (1,201 of whom had the nodal phenotype) and 1,906 control subjects from 2 case-control studies and a population-based cohort in the UK were studied. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated for the risk of total joint replacement in association with age, sex, body mass index (BMI), height, and prevalence of the T allele in the GDF5 rs143383 polymorphism. ORs for total joint replacement were compared between cases of nodal OA and cases of non-nodal OA and between patients who underwent TKR and those who underwent THR. RESULTS: Age, sex, and BMI had significantly higher ORs for an association with total joint replacement in nodal OA cases than in non-nodal OA cases. The GDF5 polymorphism was significantly associated with THR in cases of nodal OA, but not in cases of non-nodal OA, and increased height was a risk factor for THR in non-nodal OA cases only. Female sex was a protective risk factor for TKR in non-nodal OA cases (OR 0.60, 95% CI 0.52-0.70) but was predisposing for TKR in the nodal form of OA (OR 1.83, 95% CI 1.49-2.26). The nodal phenotype was associated with a significantly higher risk of undergoing both THR and TKR (OR 1.46, 95% CI 1.09-1.94) and also a significantly higher risk of bilateral TKR (OR 1.70, 95% CI 1.37-2.11), but, paradoxically, was associated with a lower risk of bilateral THR (OR 0.72, 95% CI 0.56-0.91). CONCLUSION: Nodal and non-nodal forms of large joint OA have significantly different risk factors and outcomes, indicating a different etiology for the 2 forms of OA. With regard to the likelihood of undergoing THR, this appears to be, at least in part, genetically determined. |
spellingShingle | Valdes, A McWilliams, D Arden, N Doherty, SA Wheeler, M Muir, K Zhang, W Cooper, C Maciewicz, R Doherty, M Involvement of different risk factors in clinically severe large joint osteoarthritis according to the presence of hand interphalangeal nodes. |
title | Involvement of different risk factors in clinically severe large joint osteoarthritis according to the presence of hand interphalangeal nodes. |
title_full | Involvement of different risk factors in clinically severe large joint osteoarthritis according to the presence of hand interphalangeal nodes. |
title_fullStr | Involvement of different risk factors in clinically severe large joint osteoarthritis according to the presence of hand interphalangeal nodes. |
title_full_unstemmed | Involvement of different risk factors in clinically severe large joint osteoarthritis according to the presence of hand interphalangeal nodes. |
title_short | Involvement of different risk factors in clinically severe large joint osteoarthritis according to the presence of hand interphalangeal nodes. |
title_sort | involvement of different risk factors in clinically severe large joint osteoarthritis according to the presence of hand interphalangeal nodes |
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