K Edwards1, K M Leyland2, M T Sanchez-Santos3, C P Arden4, T D Spector5, A E Nelson6, J M Jordan7, M Nevitt8, D J Hunter9, N K Arden10. 1. Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford UK; Arthritis Research UK Sports Exercise and Osteoarthritis Centre of Excellence, University of Oxford, UK. Electronic address: katherine.edwards@ndorms.ox.ac.uk. 2. Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford UK; MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK. Electronic address: kirsten.leyland@bristol.ac.uk. 3. Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford UK; Arthritis Research UK Sports Exercise and Osteoarthritis Centre of Excellence, University of Oxford, UK. Electronic address: maria.sanchez@ndorms.ox.ac.uk. 4. Arthritis Research UK Sports Exercise and Osteoarthritis Centre of Excellence, University of Oxford, UK. Electronic address: lottie.arden@hotmail.com. 5. Twin Research and Genetic Epidemiology, Kings College, London, UK. Electronic address: tim.spector@kcl.ac.uk. 6. Dept of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Thurston Arthritis Research Centre, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. Electronic address: amanda_nelson@med.unc.edu. 7. Dept of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Thurston Arthritis Research Centre, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. Electronic address: joanne_jordan@med.unc.edu. 8. UCSF School of Medicine, San Francisco, CA, USA. Electronic address: mnevitt@psg.ucsf.edu. 9. Chromatic Innovation Limited, Birmingham, UK. Electronic address: david@chromaticinnovation.com. 10. Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford UK; Arthritis Research UK Sports Exercise and Osteoarthritis Centre of Excellence, University of Oxford, UK; University of Sydney, Australia. Electronic address: nigel.arden@ndorms.ox.ac.uk.
Abstract
OBJECTIVE: This paper aims to (i) identify differences in measures of hip morphology between four racial groups using anteroposterior (AP) hip x-rays, and (ii) examine whether these differences vary by sex. METHODS: 912 hip x-rays (456 individuals) from four racial groups (European Caucasians, American Caucasians, African Americans and Chinese) were obtained. Males and females (45-75 years) with no radiographic hip OA (Kellgren and Lawrence < Grade 2 or Croft < Grade 1) were included. Eleven features of hip joint morphology were analysed. Linear regression with generalised estimating equations (GEE) was used to determine race and sex differences in hip morphology. Post-hoc Bonferroni procedure was used to adjust for multiple comparisons. RESULTS: The final analysis included 875 hips. Chinese hips showed significant differences for the majority of measures to other racial groups. Chinese were characterised by more shallow and narrow acetabular sockets, reduced femoral head coverage, smaller femoral head diameter, and a lesser angle of alignment between the femoral neck and shaft. Variation was found between other racial groups, but with few statistically significant differences. The average of lateral centre edge angle, minimum neck width and neck length differed between race and sex (p-value for interaction < 0.05). CONCLUSIONS: Significant differences were found in measures of morphology between Chinese hips compared to African Americans or Caucasian groups; these may explain variation in hip OA prevalence rates between these groups and the lower rate of hip OA in Chinese. Sex differences were also identified, which may further explain male-female prevalence differences for OA.
OBJECTIVE: This paper aims to (i) identify differences in measures of hip morphology between four racial groups using anteroposterior (AP) hip x-rays, and (ii) examine whether these differences vary by sex. METHODS: 912 hip x-rays (456 individuals) from four racial groups (European Caucasians, American Caucasians, African Americans and Chinese) were obtained. Males and females (45-75 years) with no radiographic hip OA (Kellgren and Lawrence < Grade 2 or Croft < Grade 1) were included. Eleven features of hip joint morphology were analysed. Linear regression with generalised estimating equations (GEE) was used to determine race and sex differences in hip morphology. Post-hoc Bonferroni procedure was used to adjust for multiple comparisons. RESULTS: The final analysis included 875 hips. Chinese hips showed significant differences for the majority of measures to other racial groups. Chinese were characterised by more shallow and narrow acetabular sockets, reduced femoral head coverage, smaller femoral head diameter, and a lesser angle of alignment between the femoral neck and shaft. Variation was found between other racial groups, but with few statistically significant differences. The average of lateral centre edge angle, minimum neck width and neck length differed between race and sex (p-value for interaction < 0.05). CONCLUSIONS: Significant differences were found in measures of morphology between Chinese hips compared to African Americans or Caucasian groups; these may explain variation in hip OA prevalence rates between these groups and the lower rate of hip OA in Chinese. Sex differences were also identified, which may further explain male-female prevalence differences for OA.
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