Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences · 2025
[A long-term review for radiographic parameters of hips in axial spondyloarthritis patients with end-stage hip involvement: A 24-year trend analysis from a single high-volume tertiary center].
Аннотация на английскомСтатьяНазвание и аннотация: Перевод в очереди
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Wu Xinfeng, Man Siliang, Chen Dazhao, Hua Yong, Wen Xijie, Ding Yingyue, Zhang Liang, Hou Xiujuan
Аннотация
OBJECTIVE: To evaluate the characteristics and their change trends of major radiographic parameters of hips in axial spondyloarthritis (axSpA) patients with end-stage hip involvement from a single high-volume tertiary center over a 24-year period.
METHODS: Between 2001 and 2024, the radiographic trends of hips in axSpA patients with end-stage hip involvement were retrospectively reviewed. These radiographic parameters included bony ankylosis, acetabular protrusio, dislocation, obturator foramen ratio (OFR), canal flare index (CFI) and neck shaft angle (NSA). The baseline demographic, disease-related and laboratory parameters before surgery were also collected. Trend analyses over the study period were assessed using the Jonkheere-Terpstra trend test or the Cochran-Armitage trend test for clinical and radiographic parameters. All the joints were divided into the 2001-2012 group and 2013-2024 group according to the year of surgery, and the intergroup comparisons were conducted to further elucidate temporal changes.
RESULTS: The overall incidence of bony ankylosis, acetabular protrusio and dislocation before operation were 40.2%, 14.8% and 9.8%, respectively. The median value of OFR, CFI and NSA were 1.5 (1.2, 1.7), 3.2 (2.6, 3.8) and 141.0° (135.0°, 148.0°), respectively. Notably, only the value of OFR demonstrated increasing trend (P=0.001) among these radiographic parameters of hip, although some clinical parameters demonstrated increasing trend [hemoglobin (Hb) (P < 0.001), albumin (ALB) (P < 0.001), short form 12-item health survey (SF-12) physical component summary (PCS) (P=0.005), Harris hip score (HHS) (P=0.003)] or decreasing trend [erythrocyte sedimentation rate (ESR) (P < 0.001), C-reactive protein (CRP) (P < 0.001), Bath ankylosing spondylitis disease activity index (BASDAI) (P=0.013), Bath ankylosing spondylitis functional index (BASFI) (P < 0.001)]. The results of intergroup comparisons between 2001-2012 inpatient group (n=421) and 2013-2024 inpatient group (n=577) showed that no significant differences were found for these radiographic parameters of hip, although some clinical parameters were significantly different, including gender (P=0.004), body mass index (BMI) (P=0.002), age at disease onset (P < 0.001) and HHS (P < 0.001).
CONCLUSION: The radiographic parameters of hip in axSpA patients with end-stage hip involvement did not show a trend of improvement over time, despite observed improvements in disease activity control and functional status. This dissociation between clinical improvement and persistent structural damage presents considerable technical challenges for subsequent surgical reconstruction with total hip arthroplasty.
METHODS: Between 2001 and 2024, the radiographic trends of hips in axSpA patients with end-stage hip involvement were retrospectively reviewed. These radiographic parameters included bony ankylosis, acetabular protrusio, dislocation, obturator foramen ratio (OFR), canal flare index (CFI) and neck shaft angle (NSA). The baseline demographic, disease-related and laboratory parameters before surgery were also collected. Trend analyses over the study period were assessed using the Jonkheere-Terpstra trend test or the Cochran-Armitage trend test for clinical and radiographic parameters. All the joints were divided into the 2001-2012 group and 2013-2024 group according to the year of surgery, and the intergroup comparisons were conducted to further elucidate temporal changes.
RESULTS: The overall incidence of bony ankylosis, acetabular protrusio and dislocation before operation were 40.2%, 14.8% and 9.8%, respectively. The median value of OFR, CFI and NSA were 1.5 (1.2, 1.7), 3.2 (2.6, 3.8) and 141.0° (135.0°, 148.0°), respectively. Notably, only the value of OFR demonstrated increasing trend (P=0.001) among these radiographic parameters of hip, although some clinical parameters demonstrated increasing trend [hemoglobin (Hb) (P < 0.001), albumin (ALB) (P < 0.001), short form 12-item health survey (SF-12) physical component summary (PCS) (P=0.005), Harris hip score (HHS) (P=0.003)] or decreasing trend [erythrocyte sedimentation rate (ESR) (P < 0.001), C-reactive protein (CRP) (P < 0.001), Bath ankylosing spondylitis disease activity index (BASDAI) (P=0.013), Bath ankylosing spondylitis functional index (BASFI) (P < 0.001)]. The results of intergroup comparisons between 2001-2012 inpatient group (n=421) and 2013-2024 inpatient group (n=577) showed that no significant differences were found for these radiographic parameters of hip, although some clinical parameters were significantly different, including gender (P=0.004), body mass index (BMI) (P=0.002), age at disease onset (P < 0.001) and HHS (P < 0.001).
CONCLUSION: The radiographic parameters of hip in axSpA patients with end-stage hip involvement did not show a trend of improvement over time, despite observed improvements in disease activity control and functional status. This dissociation between clinical improvement and persistent structural damage presents considerable technical challenges for subsequent surgical reconstruction with total hip arthroplasty.