Low prevalence of radiographic hip osteoarthritis and its discordance with hip pain: A nationwide study in Korea

Abstract

AimThis study aimed to evaluate the prevalence and associated factors of radiographic hip osteoarthritis (OA) in the Korean community‐dwelling population.MethodsThis study included 11 814 individuals (5025 men and 6789 women) ≥50 years of age from the Korea National Health and Nutrition Examination Surveys. Radiographic hip OA was defined as having a Kellgren–Lawrence grading scale score ≥2. Painful hip OA was defined as radiographic hip OA with the presence of hip pain. The prevalence of radiographic hip OA was evaluated with respect to age group, sex and presence of hip pain. The associations of sociodemographic and clinical variables with hip OA and hip pain were assessed using multivariable logistic regression analyses.ResultsThe weighted prevalence of radiographic hip OA and painful hip OA was 1.1% and 0.2%, respectively, in Korea. Older age (≥75 years) and male sex were independently associated with radiographic hip OA and painless hip OA. Comorbid musculoskeletal pain (knee pain) was independently associated with painful hip OA. The difference between painful and painless hip OA was the presence of comorbid musculoskeletal pain (knee pain and low back pain). Although hip pain was more common in women than in men, it was associated with the severity of hip OA only in men.ConclusionsRadiographic hip OA is rare in Korean middle‐aged and elderly people. Furthermore, hip pain is infrequent in radiographic hip OA. Geriatr Gerontol Int 2021; 21: 20–26.

Association between hip pain and radiographic hip osteoarthritis in primary care: the CHECK cohort

“…This showed only a marginal effect on the ORs, suggesting that hip pain is not associated with a higher likelihood of having hip ROA in the contralateral pain-free hip. However, in a prior study, knee pain was associated with hip ROA (17), which could indicate that our observed association might underestimate the true relation in the population or that the OR of knee pain is simply different from contralateral hip pain. Secondly, we used radiographic K&L scores in our analyses that were read and scored with images paired and in known sequence (26).…”

“…In prior research, definitions for definite and severe ROA differed considerably, as did pain definitions. Hence, the odds ratios (OR) differed substantially, ranging from 1.6 to 123.4 for severe and 1.3 to 2.8 for definite ROA (16,17,19). Since the symptomatic hip ROA prevalence was low in these studies, results were imprecise.…”

“…Additionally, in one study only participants >60 years were analysed and another analysed these associations only in men, because of an absence of severe ROA in women. Also, pain was related to definite ROA in both sexes in one study (18), while in another study it was associated with severe ROA in men, but not in women (17). Many scientific studies on hip OA therapies, including conservative interventions (e.g.…”

“…However, these recommendations are purely based on data obtained in knee OA, while OA in the hip joint is thought to be distinctively different from OA in the knee joint (15). The association between hip pain and hip ROA remains uncertain, for relevant literature is scarce and inconsistent (16)(17)(18)(19). In prior research, definitions for definite and severe ROA differed considerably, as did pain definitions.…”

Individuals With Pre-arthritic Hip Pain Walk With Hip Motion Alterations Common in Individuals With Hip OA

“…In this same study, those with worsening hip structure also had less hip extension, although not significantly so. The presence of structural damage is not tightly linked to hip pain (Birrell et al, 2005 ; Heerey et al, 2018 ; Park et al, 2021 ). Worsening pain has been associated with limited hip extension and external rotation during walking in females with mild to moderate hip OA (Tateuchi et al, 2019 ).…”