Disabling hip osteoarthritis: gender, body mass, health and functional status correlates
Ray Marks
DOI: 10.4236/health.2010.27106   PDF    HTML     4,942 Downloads   8,575 Views   Citations


Objective: To examine gender differences in self-reported pain and function before and after hip replacement surgery and the extent to which overweight, comorbidities and muscular status impact pain and function in adults with disabling end-stage hip joint osteoarthritis. Setting: Orthopedic Hospital Setting on the East Coast of the United States. Study Design: Cross-sectional retrospective chart review. Methods: The desired demographic, physical and psychological attributes of 1040 adults with end-stage hip osteoarthritis hospitalized for hip surgery were recorded and subjected to comparison and correlational analyses. These data included gender, self-reported weight, height, numbers and nature of physical and psychological comorbidities, pain intensity, ambulatory capacity and discharge destination. Sub-group analyses of 808 candidates hospitalized for primary unilateral surgery were also conducted using SPSS 16. Results: There were significant (p < 0.05) associations between gender, pain scores, comorbidity numbers and ambulatory capacity. Specifically, women who exhibited higher comorbid disease rates than men, exhibited higher pre-surgery pain levels and greater functional limitations in walking ability before and after surgery than men with the same condition. In sub-group analyses of men and women with the same mean age, comorbid prevalence rates, and body mass indices, women were found to have significantly higher ideal weights on average than men, and those with higher ideal weights recovered more slowly after surgery (p < 0.05). Conclusion: The presentation of hip joint osteoarthritis is not uniform, and may be impacted differentially by gender. Women with high ideal body weights, may be specifically impacted. Whether genetic or other factors account for gender differences in pain and function among adults with disabling hip osteoarthritis observation needs to be examined.

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Marks, R. (2010) Disabling hip osteoarthritis: gender, body mass, health and functional status correlates. Health, 2, 696-704. doi: 10.4236/health.2010.27106.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Van Dijk, G.M., Veenhof, C., Lankhorst, G.J. and Dekker, J. (2009) Limitations in patients with osteoarthritis of the hip and knee: The relationship with body functions, comorbidity and cognitive function. Disability and Rehabilitation, 31(20), 1685-1691.
[2] Van Dijk, G.M., Veenhof, C., Schellevis, F., Hulsmans, H., Bakker, J.P.J, Arwert, H., Dekker, J.H.M., Lankhorst, G.J. and Dekker, J (2008) Comorbidity, limitations in activities and pain in patients with osteoarthritis. BMC Musculoskeletal Disorders, 9(26), 95.
[3] Joost, D., Van Dijk, G.M. and Veenhof, C. (2009) Risk factors for functional decline in osteoarthritis of the hip or knee. Current Opinion in Rheumatology, 21(5), 520524.
[4] O’Connor, M.I. (2006) Osteoarthritis of the hip and knee: Sex and gender differences. Orthopedic Clinicis of North America, 37(4), 559-568.
[5] Felson, D.T. (2004) An update on the pathogenesis and epidemiology of osteoarthritis. Radiological Clinics of North America, 42(1), 1-9.
[6] Cecchi, F., Mannoni, A., Molino-Lova, R., Ceppatelli, S., Benvenuti, E., Bandinelli, S., Lauretani, F., Macchi, C. and Ferrucci, L. (2008) Epidemiology of hip and knee pain in a community based sample of Italian persons aged 65 and older. Osteoarthritis Cartilage, 16(9), 10391046.
[7] Maillefert, J.F., Guegen, A., Monreal, M., Nguyen, M., Berdah, L., Lequesne M., Mazieres B, Vignon, E. and Dougados, M. (2003) Sex differences in hip osteoarthritis: Results of a longitudinal study in 508 patients. Annals of the Rheumatic Diseases, 62(10), 931-934.
[8] Dougados, M., Guegen, A., Mguyen, M., Berdah, L., Lequesne, M., Mazieres, B. and Vignon, E. (1996) Radiological progression of hip osteoarthritis: Definition, risk factors and correlations with clinical status. Annals of the Rheumatic Diseases, 55(6), 356-362.
[9] Tuominen, U., Blom, M., Hirvonen, J., Seitsalo, S., Lehto, M., Paavolainen, P., Hietaniena, K., Rissanen, P. and Sintonen, H. (2007) The effect of co-morbidities on health-related quality of life in patients placed on the waiting list for total joint replacement. Health and Quality of Life Outcomes, 5(19), 16.
[10] Chung, C.Y., Park, M.S., Lee, K.M., Lee, S.H., Kim, T.K., Kim, K.W., Park, J.H. and Lee, J.J. (2009) Hip osteoarthritis and risk factors in elderly Korean population. Osteoarthritis Cartilage, 18(3), 312-316.
[11] Franklin, J., Ingvarsson, T., Englund, M. And Lohmander, L.S. (2009). Sex differences in the association between body mass index and total hip or knee joint replacement resulting from osteoarthritis. Annals of the Rheumatic Diseases, 68(4), 536-540.
[12] Lau, E.C., Cooper, C., Lam, D., Chan, V.N.H., Tsang, K.K. and Sham, A. (2000) Factors associated with osteoarthritis of the hip and knee in Hong Kong Chinese: obesity, joint injury, and occupational activities. American Journal of Epidemiology, 152(9), 855-862.
[13] Harrison, P.J. and Tunbridge, E.M. (2008) CatecholO-Methyltransferase (COMT): A gene contributing to sex differences in brain function, and to sexual dimorphism in the predisposition to psychiatric disorders. Neuropsychopharmacology, 33(13), 3037-3045.
[14] Petterson, S.C., Raisis, L., Bodenstab, A. and SnyderMackler, L. (2007) Disease-specific gender differences among total knee arthroplasty candidates. Journal ofBone and Joint Surgery, 89(11), 2327-2333.
[15] Rasch, A., Bystrom, A.H., Dalen, N. and Berg, H.E. (2007) Reduced muscle radiological density, cross-sectional area, and strength of major hip and knee muscles in 22 patients with hip osteoarthritis. Acta Orthopaedica, 78(4), 505-510.
[16] Juhakoski, R., Tenhonen, S., Anttonene, T., Kauppinen, T. and Aroski, J.P. (2008) Factors affecting self-reported pain and physical function in patients with hip osteoarthritis. Archives of Physical Medicine and Rehabilitation, 89(6), 1066-1073.
[17] Dieppe, P., Judge, A., Williams, S., Ikwueke, I., Guenther, K.P., Floeren, M., et al. (2009). Variations in the pre-operative status of patients coming to primary hip replacement for osteoarthritis in European orthopaedic centers. BMC Musculoskeletal Disorders, 10, 19.
[18] Wang, A., Hall, S., Gilbey, H. and Ackland, T. (1997) Patient variability and the design of clinical pathways after primary total hip replacement surgery. Journal of Quality Clinical Practice, 17(3), 123-129.
[19] Lethbridge-Cejku, M., Helmick, C.G. and Popovic, J. R. Hospitalizations for arthritis and other rheumatic conditions: Data from 1997. National Hospital Discharge Survey, 41(12), 1367-1373.
[20] Juhakoski, R., Heliovaara, M., Impivaara, O., Kroger, H., Knekt, P., Lauren, H. and Aroski, J.P. (2009) Risk factors for the development of hip osteoarthritis: A populationbased prospective survey. Rheumatology (Oxford), 48(1), 83-87.
[21] Lui, B., Balkwill, A., Banks, E., Cooper, C., Green, J. and Beral, V. (2007) Relationship of height, weight and body mass index to the risk of hip and knee replacements in middle-aged women. Rheumatology, 46(5), 861-867.
[22] Greenfield, S., Apolone, G., McNeil, B.J. and Cleary, P.D. (1993) The importance of co-existent disease in the occurrence of postoperative complications and one-year recovery in patients undergoing total hip replacement. Medical Care, 31(2), 141-154.
[23] Peters, T.J., Sanders, C., Dieppe. P. and Donovan, J. (2005) Factors associated with change in pain and disability over time: A community-based prospective observational study of hip and knee osteoarthritis. British Journal of General Practice, 55(512), 205-211.
[24] Gupta, S., Hawker, G.A., Laporte, A., Croxford, R. and Coyte, P.C. (2005) The economic burden of disabling hip and knee osteoarthritis (OA) from the perspective of individuals living with this condition. Rheumatology (Oxford). 44(12), 1531-1537.
[25] Theis, K.A., Helmick, C.G. and Hootman, J.M. (2007) Arthritis burden and impact are greater among U.S. women than men: Intervention opportunities. Journal of Womens Health, 16(4), 441-453.
[26] Rosemann, T., Laux, G. and Szecsenyi, J. (2007) Osteoarthritis: Quality of life, comorbidities, medication and health service utilization assessed in a large sample of primary care patients. Journal of Orthopedic Surgery Research, 2, 12.
[27] Katz, J.N., Wright, E.A., Guadagnoli, E., Liang, M.H., Karlson, E.W. and Cleary, P.D. (1994) Differences between men and women undergoing orthopedic surgery for degenerative arthritis. Arthritis and Rheumatism, 37(5), 687-694.
[28] Jorring, K. (1980) Osteoarthritis of the hip. Epidemiology and clinical role. Acta Orthopedica Scandinavica, 51(3), 523-530.
[29] Tepper, S. and Hochberg, M.C. (1993) Factors associated with hip osteoarthritis: Data from the First National Health and Nutrition Examination Survey (NHANES-1). American Journal of Epidemiology, 137(10), 1081-1088.
[30] Kadam, U.T., Jordan, K. and Croft, P.R. (2004) Clinical comorbidity in patients with osteoarthritis: A case-control study of general practice consulters in England and Wales. Annals of the Rheumatic Diseases, 63(4), 408414.

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