title: Variations in Hip Shape Are Associated with Radiographic Knee Osteoarthritis: Cross-sectional and Longitudinal Analyses of the Johnston County Osteoarthritis Project.
abstract: OBJECTIVE
  Hip shape by statistical shape modeling (SSM) is associated with hip radiographic osteoarthritis (rOA). We examined associations between hip shape and knee rOA given the biomechanical interrelationships between these joints.
  
  
  METHODS
  Bilateral baseline hip shape assessments [for those with at least 1 hip with a Kellgren-Lawrence arthritis grading scale (KL) 0 or 1] from the Johnston County Osteoarthritis Project were available. Proximal femur shape was defined on baseline pelvis radiographs and evaluated by SSM, producing mean shape and continuous variables representing independent modes of variation (14 modes = 95% of shape variance). Outcomes included prevalent [baseline KL ≥ 2 or total knee replacement (TKR)], incident (baseline KL 0/1 with followup ≥ 2), and progressive knee rOA (KL increase of ≥ 1 or TKR). Limb-based logistic regression models for ipsilateral and contralateral comparisons were adjusted for age, sex, race, body mass index (BMI), and hip rOA, accounting for intraperson correlations.
  
  
  RESULTS
  We evaluated 681 hips and 682 knees from 342 individuals (61% women, 83% white, mean age 62 yrs, BMI 29 kg/m(2)). Ninety-nine knees (15%) had prevalent rOA (4 knees with TKR). Lower modes 2 and 3 scores were associated with ipsilateral prevalent knee rOA, and only lower mode 3 scores were associated with contralateral prevalent knee rOA. No statistically significant associations were seen for incident or progressive knee rOA.
  
  
  CONCLUSIONS
  Variations in hip shape were associated with prevalent, but not incident or progressive, knee rOA in this cohort, and may reflect biomechanical differences between limbs, genetic influences, or common factors related to both hip shape and knee rOA.
authors.affiliation: From the Thurston Arthritis Research Center, University of North Carolina at Chapel Hill; Department of Medicine, and Department of Radiology, and Department of Orthopedics, University of North Carolina at Chapel Hill; Department of Epidemiology, and Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill; Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; University of California at San Francisco, San Francisco; University of California at Davis, Sacramento, California, USA; Musculoskeletal Research Programme, University of Aberdeen, Aberdeen, UK.A.E. Nelson, MD, MSCR, Thurston Arthritis Research Center, and Department of Medicine, University of North Carolina at Chapel Hill; Y.M. Golightly, PT, PhD, Thurston Arthritis Research Center, and Department of Epidemiology, Gillings School of Global Public Health, and Injury Prevention Research Center, University of North Carolina at Chapel Hill; J.B. Renner, MD, Department of Radiology, University of North Carolina at Chapel Hill; T.A. Schwartz, DrPH, Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill; F. Liu, MS, University of California at San Francisco; J.A. Lynch, PhD, University of California at San Francisco; J.S. Gregory, PhD, Musculoskeletal Research Programme, University of Aberdeen; R.M. Aspden, PhD, DSc, Musculoskeletal Research Programme, University of Aberdeen; N.E. Lane, MD, University of California at Davis; J.M. Jordan, MD, MPH, Thurston Arthritis Research Center, and Department of Medicine and Department of Orthopedics, and Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill. aenelson@med.unc.edu.
authors.forename: Amanda E
authors.initials: AE
authors.lastname: Nelson
authors.affiliation: From the Thurston Arthritis Research Center, University of North Carolina at Chapel Hill; Department of Medicine, and Department of Radiology, and Department of Orthopedics, University of North Carolina at Chapel Hill; Department of Epidemiology, and Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill; Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; University of California at San Francisco, San Francisco; University of California at Davis, Sacramento, California, USA; Musculoskeletal Research Programme, University of Aberdeen, Aberdeen, UK.A.E. Nelson, MD, MSCR, Thurston Arthritis Research Center, and Department of Medicine, University of North Carolina at Chapel Hill; Y.M. Golightly, PT, PhD, Thurston Arthritis Research Center, and Department of Epidemiology, Gillings School of Global Public Health, and Injury Prevention Research Center, University of North Carolina at Chapel Hill; J.B. Renner, MD, Department of Radiology, University of North Carolina at Chapel Hill; T.A. Schwartz, DrPH, Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill; F. Liu, MS, University of California at San Francisco; J.A. Lynch, PhD, University of California at San Francisco; J.S. Gregory, PhD, Musculoskeletal Research Programme, University of Aberdeen; R.M. Aspden, PhD, DSc, Musculoskeletal Research Programme, University of Aberdeen; N.E. Lane, MD, University of California at Davis; J.M. Jordan, MD, MPH, Thurston Arthritis Research Center, and Department of Medicine and Department of Orthopedics, and Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill.
authors.forename: Yvonne M
authors.initials: YM
authors.lastname: Golightly
authors.affiliation: From the Thurston Arthritis Research Center, University of North Carolina at Chapel Hill; Department of Medicine, and Department of Radiology, and Department of Orthopedics, University of North Carolina at Chapel Hill; Department of Epidemiology, and Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill; Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; University of California at San Francisco, San Francisco; University of California at Davis, Sacramento, California, USA; Musculoskeletal Research Programme, University of Aberdeen, Aberdeen, UK.A.E. Nelson, MD, MSCR, Thurston Arthritis Research Center, and Department of Medicine, University of North Carolina at Chapel Hill; Y.M. Golightly, PT, PhD, Thurston Arthritis Research Center, and Department of Epidemiology, Gillings School of Global Public Health, and Injury Prevention Research Center, University of North Carolina at Chapel Hill; J.B. Renner, MD, Department of Radiology, University of North Carolina at Chapel Hill; T.A. Schwartz, DrPH, Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill; F. Liu, MS, University of California at San Francisco; J.A. Lynch, PhD, University of California at San Francisco; J.S. Gregory, PhD, Musculoskeletal Research Programme, University of Aberdeen; R.M. Aspden, PhD, DSc, Musculoskeletal Research Programme, University of Aberdeen; N.E. Lane, MD, University of California at Davis; J.M. Jordan, MD, MPH, Thurston Arthritis Research Center, and Department of Medicine and Department of Orthopedics, and Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill.
authors.forename: Jordan B
authors.initials: JB
authors.lastname: Renner
authors.affiliation: From the Thurston Arthritis Research Center, University of North Carolina at Chapel Hill; Department of Medicine, and Department of Radiology, and Department of Orthopedics, University of North Carolina at Chapel Hill; Department of Epidemiology, and Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill; Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; University of California at San Francisco, San Francisco; University of California at Davis, Sacramento, California, USA; Musculoskeletal Research Programme, University of Aberdeen, Aberdeen, UK.A.E. Nelson, MD, MSCR, Thurston Arthritis Research Center, and Department of Medicine, University of North Carolina at Chapel Hill; Y.M. Golightly, PT, PhD, Thurston Arthritis Research Center, and Department of Epidemiology, Gillings School of Global Public Health, and Injury Prevention Research Center, University of North Carolina at Chapel Hill; J.B. Renner, MD, Department of Radiology, University of North Carolina at Chapel Hill; T.A. Schwartz, DrPH, Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill; F. Liu, MS, University of California at San Francisco; J.A. Lynch, PhD, University of California at San Francisco; J.S. Gregory, PhD, Musculoskeletal Research Programme, University of Aberdeen; R.M. Aspden, PhD, DSc, Musculoskeletal Research Programme, University of Aberdeen; N.E. Lane, MD, University of California at Davis; J.M. Jordan, MD, MPH, Thurston Arthritis Research Center, and Department of Medicine and Department of Orthopedics, and Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill.
authors.forename: Todd A
authors.initials: TA
authors.lastname: Schwartz
authors.affiliation: From the Thurston Arthritis Research Center, University of North Carolina at Chapel Hill; Department of Medicine, and Department of Radiology, and Department of Orthopedics, University of North Carolina at Chapel Hill; Department of Epidemiology, and Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill; Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; University of California at San Francisco, San Francisco; University of California at Davis, Sacramento, California, USA; Musculoskeletal Research Programme, University of Aberdeen, Aberdeen, UK.A.E. Nelson, MD, MSCR, Thurston Arthritis Research Center, and Department of Medicine, University of North Carolina at Chapel Hill; Y.M. Golightly, PT, PhD, Thurston Arthritis Research Center, and Department of Epidemiology, Gillings School of Global Public Health, and Injury Prevention Research Center, University of North Carolina at Chapel Hill; J.B. Renner, MD, Department of Radiology, University of North Carolina at Chapel Hill; T.A. Schwartz, DrPH, Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill; F. Liu, MS, University of California at San Francisco; J.A. Lynch, PhD, University of California at San Francisco; J.S. Gregory, PhD, Musculoskeletal Research Programme, University of Aberdeen; R.M. Aspden, PhD, DSc, Musculoskeletal Research Programme, University of Aberdeen; N.E. Lane, MD, University of California at Davis; J.M. Jordan, MD, MPH, Thurston Arthritis Research Center, and Department of Medicine and Department of Orthopedics, and Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill.
authors.forename: Felix
authors.initials: F
authors.lastname: Liu
authors.affiliation: From the Thurston Arthritis Research Center, University of North Carolina at Chapel Hill; Department of Medicine, and Department of Radiology, and Department of Orthopedics, University of North Carolina at Chapel Hill; Department of Epidemiology, and Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill; Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; University of California at San Francisco, San Francisco; University of California at Davis, Sacramento, California, USA; Musculoskeletal Research Programme, University of Aberdeen, Aberdeen, UK.A.E. Nelson, MD, MSCR, Thurston Arthritis Research Center, and Department of Medicine, University of North Carolina at Chapel Hill; Y.M. Golightly, PT, PhD, Thurston Arthritis Research Center, and Department of Epidemiology, Gillings School of Global Public Health, and Injury Prevention Research Center, University of North Carolina at Chapel Hill; J.B. Renner, MD, Department of Radiology, University of North Carolina at Chapel Hill; T.A. Schwartz, DrPH, Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill; F. Liu, MS, University of California at San Francisco; J.A. Lynch, PhD, University of California at San Francisco; J.S. Gregory, PhD, Musculoskeletal Research Programme, University of Aberdeen; R.M. Aspden, PhD, DSc, Musculoskeletal Research Programme, University of Aberdeen; N.E. Lane, MD, University of California at Davis; J.M. Jordan, MD, MPH, Thurston Arthritis Research Center, and Department of Medicine and Department of Orthopedics, and Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill.
authors.forename: John A
authors.initials: JA
authors.lastname: Lynch
authors.affiliation: From the Thurston Arthritis Research Center, University of North Carolina at Chapel Hill; Department of Medicine, and Department of Radiology, and Department of Orthopedics, University of North Carolina at Chapel Hill; Department of Epidemiology, and Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill; Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; University of California at San Francisco, San Francisco; University of California at Davis, Sacramento, California, USA; Musculoskeletal Research Programme, University of Aberdeen, Aberdeen, UK.A.E. Nelson, MD, MSCR, Thurston Arthritis Research Center, and Department of Medicine, University of North Carolina at Chapel Hill; Y.M. Golightly, PT, PhD, Thurston Arthritis Research Center, and Department of Epidemiology, Gillings School of Global Public Health, and Injury Prevention Research Center, University of North Carolina at Chapel Hill; J.B. Renner, MD, Department of Radiology, University of North Carolina at Chapel Hill; T.A. Schwartz, DrPH, Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill; F. Liu, MS, University of California at San Francisco; J.A. Lynch, PhD, University of California at San Francisco; J.S. Gregory, PhD, Musculoskeletal Research Programme, University of Aberdeen; R.M. Aspden, PhD, DSc, Musculoskeletal Research Programme, University of Aberdeen; N.E. Lane, MD, University of California at Davis; J.M. Jordan, MD, MPH, Thurston Arthritis Research Center, and Department of Medicine and Department of Orthopedics, and Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill.
authors.forename: Jenny S
authors.initials: JS
authors.lastname: Gregory
authors.affiliation: From the Thurston Arthritis Research Center, University of North Carolina at Chapel Hill; Department of Medicine, and Department of Radiology, and Department of Orthopedics, University of North Carolina at Chapel Hill; Department of Epidemiology, and Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill; Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; University of California at San Francisco, San Francisco; University of California at Davis, Sacramento, California, USA; Musculoskeletal Research Programme, University of Aberdeen, Aberdeen, UK.A.E. Nelson, MD, MSCR, Thurston Arthritis Research Center, and Department of Medicine, University of North Carolina at Chapel Hill; Y.M. Golightly, PT, PhD, Thurston Arthritis Research Center, and Department of Epidemiology, Gillings School of Global Public Health, and Injury Prevention Research Center, University of North Carolina at Chapel Hill; J.B. Renner, MD, Department of Radiology, University of North Carolina at Chapel Hill; T.A. Schwartz, DrPH, Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill; F. Liu, MS, University of California at San Francisco; J.A. Lynch, PhD, University of California at San Francisco; J.S. Gregory, PhD, Musculoskeletal Research Programme, University of Aberdeen; R.M. Aspden, PhD, DSc, Musculoskeletal Research Programme, University of Aberdeen; N.E. Lane, MD, University of California at Davis; J.M. Jordan, MD, MPH, Thurston Arthritis Research Center, and Department of Medicine and Department of Orthopedics, and Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill.
authors.forename: Richard M
authors.initials: RM
authors.lastname: Aspden
authors.affiliation: From the Thurston Arthritis Research Center, University of North Carolina at Chapel Hill; Department of Medicine, and Department of Radiology, and Department of Orthopedics, University of North Carolina at Chapel Hill; Department of Epidemiology, and Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill; Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; University of California at San Francisco, San Francisco; University of California at Davis, Sacramento, California, USA; Musculoskeletal Research Programme, University of Aberdeen, Aberdeen, UK.A.E. Nelson, MD, MSCR, Thurston Arthritis Research Center, and Department of Medicine, University of North Carolina at Chapel Hill; Y.M. Golightly, PT, PhD, Thurston Arthritis Research Center, and Department of Epidemiology, Gillings School of Global Public Health, and Injury Prevention Research Center, University of North Carolina at Chapel Hill; J.B. Renner, MD, Department of Radiology, University of North Carolina at Chapel Hill; T.A. Schwartz, DrPH, Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill; F. Liu, MS, University of California at San Francisco; J.A. Lynch, PhD, University of California at San Francisco; J.S. Gregory, PhD, Musculoskeletal Research Programme, University of Aberdeen; R.M. Aspden, PhD, DSc, Musculoskeletal Research Programme, University of Aberdeen; N.E. Lane, MD, University of California at Davis; J.M. Jordan, MD, MPH, Thurston Arthritis Research Center, and Department of Medicine and Department of Orthopedics, and Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill.
authors.forename: Nancy E
authors.initials: NE
authors.lastname: Lane
authors.affiliation: From the Thurston Arthritis Research Center, University of North Carolina at Chapel Hill; Department of Medicine, and Department of Radiology, and Department of Orthopedics, University of North Carolina at Chapel Hill; Department of Epidemiology, and Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill; Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; University of California at San Francisco, San Francisco; University of California at Davis, Sacramento, California, USA; Musculoskeletal Research Programme, University of Aberdeen, Aberdeen, UK.A.E. Nelson, MD, MSCR, Thurston Arthritis Research Center, and Department of Medicine, University of North Carolina at Chapel Hill; Y.M. Golightly, PT, PhD, Thurston Arthritis Research Center, and Department of Epidemiology, Gillings School of Global Public Health, and Injury Prevention Research Center, University of North Carolina at Chapel Hill; J.B. Renner, MD, Department of Radiology, University of North Carolina at Chapel Hill; T.A. Schwartz, DrPH, Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill; F. Liu, MS, University of California at San Francisco; J.A. Lynch, PhD, University of California at San Francisco; J.S. Gregory, PhD, Musculoskeletal Research Programme, University of Aberdeen; R.M. Aspden, PhD, DSc, Musculoskeletal Research Programme, University of Aberdeen; N.E. Lane, MD, University of California at Davis; J.M. Jordan, MD, MPH, Thurston Arthritis Research Center, and Department of Medicine and Department of Orthopedics, and Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill.
authors.forename: Joanne M
authors.initials: JM
authors.lastname: Jordan
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006615:Hip / Q000000981:diagnostic imaging*; D006621:Hip Joint / Q000000981:diagnostic imaging*; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000000981:diagnostic imaging*
keywords: HIP JOINT; KNEE OSTEOARTHRITIS; RADIOGRAPHY