Ray Marks1, John P Allegrante. 1. Research Division, The Hospital for Special Surgery, New York, NY 10021, USA. rm226@columbia.edu
Abstract
BACKGROUND: Although hip osteoarthritis is a common disabling condition, an incomplete understanding of all factors that contribute to hip osteoarthritis disability persists. The objective of the study was to improve our understanding of potentially preventable factors that might influence hip osteoarthritis disability by examining the prevalence and impact of selected comorbid factors potentially associated with the progression and severity of hip joint osteoarthritis among patients with end-stage hip osteoarthritis. MATERIAL/ METHODS: The medical records of 1,000 hip osteoarthritis surgical patients were assessed to specifically identify the presence or absence of comorbid conditions of the cardiac, vascular or respiratory systems. The association between the patient's functional status before and after surgery, and the presence or absence of these comorbid conditions, was assessed. RESULTS: Over 55% of the sample had at least one comorbid condition, such as hypertension or cardiac disease. After controlling for age, trauma, type of surgery and gender discrepancies, those with two or more comorbidities were found to have greater degrees of functional impairment before surgery, and lower post-operative functional status after surgery than those with no co-existent disease (p<0.05). CONCLUSIONS: Patients with end-stage hip osteoarthritis exhibit a high prevalence of vascular-related comorbidities. The disability of patients with hip osteoarthritis is increased in the presence of two or more related comorbid conditions. These findings suggest a novel focus for primary, secondary and tertiary preventive strategies.
BACKGROUND: Although hip osteoarthritis is a common disabling condition, an incomplete understanding of all factors that contribute to hip osteoarthritis disability persists. The objective of the study was to improve our understanding of potentially preventable factors that might influence hip osteoarthritis disability by examining the prevalence and impact of selected comorbid factors potentially associated with the progression and severity of hip joint osteoarthritis among patients with end-stage hip osteoarthritis. MATERIAL/ METHODS: The medical records of 1,000 hip osteoarthritis surgical patients were assessed to specifically identify the presence or absence of comorbid conditions of the cardiac, vascular or respiratory systems. The association between the patient's functional status before and after surgery, and the presence or absence of these comorbid conditions, was assessed. RESULTS: Over 55% of the sample had at least one comorbid condition, such as hypertension or cardiac disease. After controlling for age, trauma, type of surgery and gender discrepancies, those with two or more comorbidities were found to have greater degrees of functional impairment before surgery, and lower post-operative functional status after surgery than those with no co-existent disease (p<0.05). CONCLUSIONS:Patients with end-stage hip osteoarthritis exhibit a high prevalence of vascular-related comorbidities. The disability of patients with hip osteoarthritis is increased in the presence of two or more related comorbid conditions. These findings suggest a novel focus for primary, secondary and tertiary preventive strategies.
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