End-stage coxarthrosis and gonarthrosis. Aetiology, clinical patterns and radiological features of idiopathic osteoarthritis.
OBJECTIVE
To determine and compare the aetiological background, clinical patterns and radiological features of idiopathic osteoarthritis (OA) of the hip and the knee warranting arthroplasty.


METHODS
A total of 402 Caucasians consecutively undergoing total hip replacement (THR) or total knee replacement (TKR) for idiopathic OA at a major centre was surveyed.


RESULTS
Previous joint injury was more common in the TKR group (P < 0.0001). However, both groups manifested a mixed occupational background, body mass indices similar to the general population and a predominance of females (F:M = 1.3-1.4:1). The TKR group had a significantly younger age of symptom onset (56 yr) than the THR group (61 yr) but both groups had a tendency to bilateral arthroplasty (33%), nodal involvement (54-59%), a significant excess of right-sided replacements (1.8:1, THR; 2.2:1, TKR) and similar levels of pre-operative pain and disability. Up to 40% of hips manifested acetabular dysplasia and 10% possible previous slipped upper femoral epiphyses. Eighty-five per cent with end-stage coxarthrosis or gonarthrosis had an identical pattern of radiographic disease contralaterally.


CONCLUSIONS
Our data suggest the importance of a constitutional tendency to idiopathic, end-stage OA, a disorder traditionally associated with environmental factors leading to 'wear and tear'.
Chitnavis
J
J
Nuffield Orthopaedic Centre, Headington, Oxford OX3 7LD, UK and. University of California, Los Angeles, CA, USA.
Sinsheimer
J S
JS
Suchard
M A
MA
Clipsham
K
K
Carr
A J
AJ
D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000627:therapeutic use; D019644:Arthroplasty, Replacement, Hip; D019645:Arthroplasty, Replacement, Knee; D015992:Body Mass Index; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009790:Occupations; D015207:Osteoarthritis, Hip / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*; D020370:Osteoarthritis, Knee / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*; D010146:Pain / Q000188:drug therapy / Q000209:etiology; D011859:Radiography; D012737:Sex Factors; D017749:Total Quality Management
D000700:Analgesics