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Table 3 Factors predicting (indication for) total hip replacement (THR)

From: Prognostic factors for progression of osteoarthritis of the hip: a systematic review

Prognostic factor Studies Associations Best-evidence synthesis
Patient variables
 No association
  Body mass index Strong evidence for no association
  2 low risk of bias cohorts [16, 37]
5 cohorts [20, 39, 50, 51, 67]
No, no
No, no, no, negative, positive
  Female Moderate evidence for no association
  3 low risk of bias cohorts [16, 34, 37]
5 cohorts [20, 39, 50,51,52]
No, positive, no
No, no, no, no, no
  Lower educational level Moderate evidence for no association
  1 low risk of bias cohort [16]
1 cohort [39]
No
No
  Western or White ethnicity Moderate evidence for no association
  1 low risk of bias cohort [16]
1 cohort [39]
No
No
  Alcohol consumption Limited evidence for no association
  1 low risk of bias cohort [16] No
 Conflicting evidence
  Higher age at baseline Conflicting evidence
  3 low risk of bias cohorts [16, 34, 37]
5 cohorts [20, 39, 50, 51, 67]
No, positive,no
No, positive$, no, no, positive
Disease characteristics
 Faster or more progression
  Lower global assessment (self-reported) at baseline Moderate evidence for faster or more progression
  1 low risk of bias cohort [37]
2 cohorts [39, 50]
Positive
Positive, positive
  Previous use of NSAIDs Limited evidence for more progression
  1 low risk of bias cohort [37] Positive
 No association
  Longer duration of symptoms at baseline Moderate evidence for no association
  1 low risk of bias cohort [37]
1 cohort [19]
No
No
  Having another disease (comorbidity) Moderate evidence for no association
  1 low risk of bias cohort [16]
1 cohort [39]
No
No
  Morning stiffness Moderate evidence for no association
  1 low risk of bias cohort [16]
1 cohort [51]
No
No
  Use of pain medication at baseline Moderate evidence for no association
  1 low risk of bias cohort [16]
1 cohort [19]
No
No
  Presence of Heberden’s or Bouchard’s nodes Moderate evidence for no association
  1 low risk of bias cohort [16]
2 cohorts [50, 51]
No
No, no
  Previous intra-articular injection in the hip Limited evidence for no association
  1 low risk of bias cohort [37] No
 Conflicting evidence
  More limitations in physical function at baseline Conflicting evidence
  3 low risk of bias cohorts [16, 34, 37]
2 cohorts [19, 39]
Positive, positive, no
No, no
  More pain at baseline Conflicting evidence
  3 low risk of bias cohorts [16, 34, 37]
4 cohorts [19, 39, 50, 51]
Conflicted$$, positive, positive
Positive, no, positive, no
  Painful hip flexion (active or passive) Conflicting evidence
  1 low risk of bias cohort [16]
1 cohort [51]
Positive
No
  Painful hip internal rotation (active or passive) Conflicting evidence
  1 low risk of bias cohort [16]
1 cohort [51]
Positive
No
  Night pain at baseline Conflicting evidence
  2 cohorts [50, 51] Positive, no
  Limited range of motion of flexion of the hip Conflicting evidence
  1 low risk of bias cohort [16]
2 cohorts [19, 51]
Positive
Positive, no
  Limited range of motion of internal hip rotation Conflicting evidence
  1 low risk of bias cohort [16]
2 cohorts [19, 51]
Positive
Positive, no
  Limited range of motion of external hip rotation Conflicting evidence
  2 cohorts [19, 51] Positive, no
Chemical or imaging markers
 Faster or more progression
  Higher K-L grade at baseline Strong evidence for more or faster progression
  2 low risk of bias cohorts [34, 37]
1 cohorts [51]
Positive, positive
Positive
  Superior or superolateral migration of the femoral head Strong evidence for more or faster progression
  2 low risk of bias cohorts [34, 47]
1 cohort [38]
Positive, positive
Positive
  Subchondral sclerosis Strong evidence for more progression
  2 low risk of bias cohorts [16, 47] Positive, positive
  Statistical shape modeling Moderate evidence that certain modes of SSM can predict progression
  3 cohorts [11, 12, 12] Positive, positive, positive
  Joint space narrowing at baseline Moderate evidence for more or faster progression
  1 low risk of bias cohort [16]
1 cohort [67]
Positive
Positive
 No association
  Cam-type deformity (alpha angle > 60°) Limited evidence for no association
  1 low risk of bias cohort [16] No
 Conflicting evidence
  Erythrocyte sedimentation rate Conflicting evidence
  1 low risk of bias cohort [16]
1 cohort [51]
Positive
No
  Atrophic bone response (no osteophytes present) Conflicting evidence
  1 low risk of bias cohort [16]
2 cohorts [50, 51]
Positive
Positive, no
  Decrease in joint space width at baseline Conflicting evidence
  1 low risk of bias cohort [34]
1 cohort [51]
Positive
No
  Wiberg’s center edge angle (CEA) Conflicting evidence
  1 low risk of bias cohort [16]
1 cohort [20]
Negative
No
  1. $Exception: age ≥ 82 years showed a negative association with progression, compared to age ≤ 62 years
  2. $$Pain at baseline measured with NRS past week showed a statistically significant positive association with THR; pain at baseline measured with WOMAC pain showed no statistically significant association with THR