Poster Presentation Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting 2025

Busselton Healthy Ageing Study Hip DEXA scan to assess Kellgren Lawrence Hip OA Grading and DEXA scores in identifying progression to Total Hip Replacement. (119364)

Charles Inderjeeth 1 2 , Kun Zhu 3 , Diren C Inderjeeth 2 , Kevin Murray 4 , Michael Hunter 4 , Jennie Hui 4
  1. Faculty of Medicine and Dentistry, University of Western Australia, , Crawley, , Western Australia, Australia
  2. Geriatric Acute And Rehabilitation Medicine, Sir Charles Gairdner Osborne Park Health Care Group, Perth, Western Australia, Australia
  3. Department of Endocrinology, Sir Charles Gairdner Osborne Park Health Care Group, Perth, WA, Australia
  4. Population Health, University of Western Australia, Perth, WA, Australia

Aim:

Determine hip OA presence/severity from DXA using Kellgren–Lawrence criteria, assess whether OA grade and hip BMD predict future replacement, and examine correlations between OA grade and total/femoral neck BMD.

 

Method: 

Total 145 patients had THR, matched with 445 (no THR). Kellgren-Lawrence (KL) HipOA grading (0-4) was performed. Groups were compared at baseline (means and SD). Correlations between KL grades, BMD, and hip replacement status were assessed using Pearson's correlation coefficient and multivariate logistic regression analysis.

 

Result: 

590 patients (59.15% male; mean age 59.95±5.16 years, range 47.1-68.9). Patients with THR had significantly higher baseline Neck of Femur BMD (1.005 vs 0.941 g/cm2, p<0.001) and higher baseline OA grades (Higher Grade: 1.63 vs 0.93, p<0.001; Composite score: 2.79 vs 1.54, p<0.001). Males had higher OA grades compared to females (Composite score: 1.99 vs 1.65; Higher Grade: 1.17 vs 1.00). The correlation between OA grade and BMD was stronger in females (right hip: r=0.175) than males (r=0.078).  The combination of high KL grade (≥2) and low neck of femur BMD (≤0.8 g/cm2) was associated with a 4.5-fold increased risk of hip replacement (OR 4.50, 95% CI 2.61-7.75, p<0.001).

 

Conclusions: 

Identified combined KL grade and BMD as significant risk factors for hip replacement in middle-aged Australians. Predictive models incorporating both scores on DEXA could help identify high-risk patients, for early intervention. Future research should focus on developing and validating such models, as well as evaluating the effectiveness of early intervention strategies in reducing hip replacement risk based on baseline DEXA scans.