title: End-stage coxarthrosis and gonarthrosis. Aetiology, clinical patterns and radiological features of idiopathic osteoarthritis.
abstract: 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'.
authors.affiliation: Nuffield Orthopaedic Centre, Headington, Oxford OX3 7LD, UK and. University of California, Los Angeles, CA, USA.
authors.forename: J
authors.initials: J
authors.lastname: Chitnavis
authors.forename: J S
authors.initials: JS
authors.lastname: Sinsheimer
authors.forename: M A
authors.initials: MA
authors.lastname: Suchard
authors.forename: K
authors.initials: K
authors.lastname: Clipsham
authors.forename: A J
authors.initials: AJ
authors.lastname: Carr
mesh_terms: 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
chemical_list: D000700:Analgesics