Age Related Macular Degeneration and Total Hip Replacement Due to Osteoarthritis or Fracture: Melbourne Collaborative Cohort Study.
Osteoarthritis is the leading cause of total hip replacement, accounting for more than 80% of all total hip replacements. Emerging evidence suggests that osteoarthritis has a chronic inflammatory component to its pathogenesis similar to age-related macular degeneration. We evaluated the association between age-related macular degeneration and total hip replacement as proxy for severe osteoarthritis or fractured neck of femur in the Melbourne Collaborative Cohort Study. 20,744 participants had complete data on both age-related macular degeneration assessed from colour fundus photographs taken during 2003-2007 and total hip replacement. Total hip replacements due to hip osteoarthritis and fractured neck of femur during 2001-2011 were identified by linking the cohort records to the Australian Orthopedic Association National Joint Replacement Registry. Logistic regression was used to examine the association between age-related macular degeneration and risk of total hip replacement due to osteoarthritis and fracture separately, adjusted for confounders. There were 791 cases of total hip replacement for osteoarthritis and 102 cases of total hip replacement due to fractured neck of femur. After adjustment for age, sex, body mass index, smoking, and grouped country of birth, intermediate age-related macular degeneration was directly associated with total hip replacement for osteoarthritis (odds ratio 1.22, 95% CI 1.00-1.49). Late age-related macular degeneration was directly associated with total hip replacement due to fractured neck of femur (odds ratio 5.21, 95% CI2.25-12.02). The association between intermediate age-related macular degeneration and an increased 10-year incidence of total hip replacement due to osteoarthritis suggests the possibility of similar inflammatory processes underlying both chronic diseases. The association of late age-related macular degeneration with an increased 10-year incidence of total hip replacement due to fractured neck of femur may be due to an increased prevalence of fractures in those with poor central vision associated with the late complications of age-related macular degeneration.
Centre for Eye Research Australia (CERA), The University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia; Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.
Elaine W
EW
Chong
Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, Victoria, Australia.
Yuanyuan
Y
Wang
Centre for Eye Research Australia (CERA), The University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, Victoria, Australia.
Liubov D
LD
Robman
Centre for Eye Research Australia (CERA), The University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia.
Khin Zaw
KZ
Aung
Centre for Eye Research Australia (CERA), The University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia.
Galina A
GA
Makeyeva
Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia; Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Victoria, Australia.
Graham G
GG
Giles
Department of Orthopaedic, Repatriation General Hospital, Adelaide, South Australia, Australia; Australian Orthopaedic Association National Joint Replacement Registry, Discipline of Public Health, School of Population Health & Clinical Practice, University of Adelaide, Adelaide, South Australia, Australia.
Stephen
S
Graves
Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, Victoria, Australia.
Flavia M
FM
Cicuttini
Centre for Eye Research Australia (CERA), The University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia.
Robyn H
RH
Guymer
D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip; D001315:Australia; D015331:Cohort Studies; D003299:Cooperative Behavior; D005260:Female; D006620:Hip Fractures / Q000601:surgery*; D006801:Humans; D008268:Macular Degeneration / Q000150:complications*; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000601:surgery*; D012307:Risk Factors