• Arch Orthop Trauma Surg · Dec 2024

    Short-term prediction of clinical and radiographic contralateral hip osteoarthritis after index total hip arthroplasty.

    • Ana Ocokoljic, Lukas Krivec, Assil-Ramin Alimy, Alexander Simon, André Strahl, Frank Timo Beil, and Tim Rolvien.
    • Department of Trauma and Orthopaedic Surgery, Division of Orthopaedics, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
    • Arch Orthop Trauma Surg. 2024 Dec 12; 145 (1): 77.

    IntroductionPatients with primary hip osteoarthritis undergoing unilateral total hip arthroplasty (THA) often face uncertainty about the future need for arthroplasty in the contralateral hip. We aimed to identify parameters that have predictive value with regard to the necessity for contralateral THA or the development of contralateral radiographic osteoarthritis (OA) phenotypes following index surgery.Materials And MethodsIn this retrospective study, we analyzed 220 patients undergoing THA. Of these, 24.1% required contralateral THA at a mean follow-up of 18.3months. Our assessments included preoperative and follow-up pelvis radiographs as well as bone mineral density (BMD) measurement by dual-energy X-ray absorptiometry prior to index THA. Comprehensive radiological measurements such as the Kellgren-Lawrence OA grade, osteophyte evaluation as well as joint shape and alignment (including alpha and CE angles) were performed.ResultsWe identified three indicators at the initial assessment for predicting the need for contralateral THA: higher BMI (odds ratio (OR) 1.1 [95%-CI 1.0-1.2], p = 0.033), higher alpha angles (> 61.5°) (OR 2.5 [95%-CI 1.0-6.3], p = 0.045) and the presence of multiple osteophytes (OR 2.6 [95%-CI 1.4-4.9], p = 0.004). Moreover, higher alpha angles were linked to more severe radiographic OA, especially osteophytosis. Higher BMD T-scores were also associated with progressive formation of multiple and large osteophytes but not joint space narrowing.ConclusionThree factors - BMI, alpha angle, and osteophyte number - are key short-term predictors for contralateral THA after index THA. We also identified BMD as a surrogate for osteophyte formation. These findings provide novel and valuable insights for patients and surgeons regarding risks and counseling for contralateral OA and THA.© 2024. The Author(s).

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