Differences in radiographic features of knee osteoarthritis in African-Americans and Caucasians: the Johnston county osteoarthritis project.
ABSTRACT To examine racial differences in tibiofemoral joint (TFJ) and patellofemoral joint (PFJ) radiographic osteoarthritis in African-American (AA) and Caucasian men and women.
Multiple logistic regression was used to evaluate cross-sectional associations between race and tibiofemoral osteoarthritis (TF-OA) and the presence, severity and location of individual radiographic features of tibiofemoral joint osteoarthritis [TFJ-OA] (osteophytes, joint space narrowing [JSN], sclerosis and cysts) and patellofemoral joint osteoarthritis (PFJ-OA) (osteophytes, JSN and sclerosis), using data from the Johnston County Osteoarthritis Project. Proportional odds ratios (POR) assessed severity of TF-OA, TFJ and PFJ osteophytes, and JSN, adjusting for confounders. Generalized estimating equations accounted for auto-correlation of knees.
Among 3187 participants (32.5% AAs; 62% women; mean age 62 years), 6300 TFJ and 1957 PFJ were included. Compared to Caucasians, AA men were more likely to have TF-OA (adjusted odds ratio [aOR]=1.36; 95% CI, 1.00-1.86); tri-compartmental TFJ and PFJ osteophytes (aOR=3.06; 95%CI=1.96-4.78), and TFJ and PFJ sclerosis. AA women were more likely than Caucasian to have medial TFJ and tri-compartmental osteophytes (aOR=2.13; 1.55-2.94), and lateral TFJ sclerosis. AAs had more severe TF-OA than Caucasians (adjusted cumulative odds ratio [aPOR]=2.08; 95% CI, 1.19-3.64 for men; aPOR=1.56; 95% CI, 1.06-2.29 for women) and were more likely to have lateral TFJ JSN.
Compared to Caucasians, AAs were more likely to have more severe TF-OA; tri-compartmental disease; and lateral JSN. Further research to clarify the discrepancy between radiographic features in OA among races appears warranted.
- SourceAvailable from: Todd Schwartz[Show abstract] [Hide abstract]
ABSTRACT: Objective To investigate hip shape by active shape modeling (ASM) as a potential predictor of incident radiographic hip osteoarthritis (RHOA) and symptomatic hip osteoarthritis (SRHOA). Methods All hips developing RHOA from baseline (Kellgren/Lawrence [K/L] grade 0/1) to mean 6-year followup (K/L grade ≥2, 190 hips) and 1:1 control hips (K/L grade 0/1 at both times, 192 hips) were included. Proximal femur shape was defined on baseline anteroposterior pelvis radiographs and submitted to ASM, producing a mean shape and continuous variables representing independent modes of shape variation. Mode scores (n = 14, explaining 95% of shape variance) were simultaneously included in logistic regression models with incident RHOA and SRHOA as dependent variables, adjusted for intraperson correlations, sex, race, body mass index (BMI), baseline K/L grade, and/or symptoms. ResultsWe evaluated 382 hips from 342 individuals: 61% women and 83% white, with mean age 62 years and mean BMI 29 kg/m2. Several modes differed by sex and race, but no modes were associated with incident RHOA overall. Among men only, modes 1 and 2 were significantly associated (for a 1-SD decrease in mode 1 score: odds ratio [OR] 1.7 [95% confidence interval (95% CI) 1.1–2.5] and for a 1-SD increase in mode 2 score: OR 1.5 [95% CI 1.0–2.2]) with incident RHOA. A 1-SD decrease in mode 2 or 3 score increased the odds of SRHOA by 50%. Conclusion This study confirms other reports that variations in proximal femur shape have a modest association with incident hip OA. The observation of proximal femur shape associations with hip symptoms requires further investigation.01/2014; 66(1). DOI:10.1002/acr.22094
- [Show abstract] [Hide abstract]
ABSTRACT: To examine whether racial disparities in usage and outcomes of total knee and total hip arthroplasty (TKA and THA) have declined over time. We used data from the US Medicare Program (MedPAR data) for years 1991-2008 to identify four separate cohorts of patients (primary TKA, revision TKA, primary THA, revision THA). For each cohort, we calculated standardised arthroplasty usage rates for Caucasian and African-American Medicare beneficiaries for each calendar year, and examined changes in disparities over time. We examined unadjusted and adjusted outcomes (30-day readmission rate, discharge disposition etc.) for Caucasians and African-Americans, and whether disparities decreased over time. In 1991, the use of primary TKA was 36% lower for African-Americans compared with Caucasians (20.6 per 10 000 for African-Americans; 32.1 per 10 000 for Caucasians; p<0.0001); in 2008, usage of primary TKA was 40% lower for African-Americans (41.5 per 10 000 for African-Americans; 68.8 per 10 000 for Caucasians; p<0.0001) with similar findings for the other cohorts. Black-White disparities in 30-day hospital readmission increased significantly from 1991-2008 among three patient cohorts. For example in 1991 30-day readmission rates for African-Americans receiving primary TKA were 6% higher than for Caucasians; by 2008 readmission rates for African-Americans were 24% higher (p<0.05 for change in disparity). Similarly, black-white disparities in the proportion of patients discharged to home after surgery increased across the study period for all cohorts (p<0.05). In an 18-year analysis of US Medicare data, we found little evidence of declines in racial disparities for joint arthroplasty usage or outcomes.Annals of the rheumatic diseases 09/2013; 73(12). DOI:10.1136/annrheumdis-2013-203494 · 9.27 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: We aim to compare the patient profile and outcomes after TKA between the different racial groups in Singapore. Prospective data were collected from 364 patients who underwent TKA in Singapore General Hospital from January 2006 to May 2010. Patients were stratified according to ethnicity and we compared their preoperative demographic data, Short-Form 36 (SF-36), Oxford Knee (OKS) as well as Knee Society Scores (KSS). Malays were younger (62.0±5.3) at time of surgery (p=0.05) and the body mass index of Chinese (27.9±4.7) was lower than Malay (30.4±5.0) and Indian (31.5±4.5) patients (P<0.005). Malay (40.3±11.0) and Indian (39.2±9.3) patients had less favourable preoperative OKS than Chinese (35.9±7.8) patients (P<0.05). All 3 ethnic groups achieved statistically significant improvements in outcome measures but did not differ significantly between the ethnicities.The Journal of arthroplasty 07/2013; 29(2). DOI:10.1016/j.arth.2013.06.002 · 2.37 Impact Factor