AIMS The aim of this study was to estimate time to arthroplasty among patients with hip and knee osteoarthritis (OA), and to identify factors at enrolment to first-line intervention that are prognostic for progression to surgery. METHODS In this longitudinal register-based observational study, we identified 72,069 patients with hip and knee OA in the Better Management of Patients with Osteoarthritis Register (BOA), who were referred for first-line OA intervention, between May 2008 and December 2016. Patients were followed until the first primary arthroplasty surgery before 31 December 2016, stratified into a hip and a knee OA cohort. Data were analyzed with Kaplan-Meier and multivariable-adjusted Cox regression. RESULTS At five years, Kaplan-Meier estimates showed that 46% (95% confidence interval (CI) 44.6 to 46.9) of those with hip OA, and 20% (95% CI 19.7 to 21.0) of those with knee OA, had progressed to arthroplasty. The strongest prognostic factors were desire for surgery (hazard ratio (HR) hip 3.12 (95% CI 2.95 to 3.31), HR knee 2.72 (95% CI 2.55 to 2.90)), walking difficulties (HR hip 2.20 (95% CI 1.97 to 2.46), HR knee 1.95 (95% CI 1.73 to 2.20)), and frequent pain (HR hip 1.56 (95% CI 1.40 to 1.73), HR knee 1.77 (95% CI 1.58 to 2.00)). In hip OA, the probability of progression to surgery was lower among those with comorbidities (e.g. ≥ four conditions; HR 0.64 (95% CI 0.59 to 0.69)), with no detectable effects in the knee OA cohort. Instead, being overweight or obese increased the probability of OA progress in the knee cohort (HR 1.25 (95% CI 1.15 to 1.37)), but not among those with hip OA. CONCLUSION Patients with hip OA progressed faster and to a greater extent to arthroplasty than patients with knee OA. Progression was strongly influenced by patients' desire for surgery and by factors related to severity of OA symptoms, but factors not directly related to OA symptoms are also of importance. However, a large proportion of patients with OA do not seem to require surgery within five years, especially among those with knee OA. Cite this article: Bone Joint J 2022;104-B(7):792-800.

中文翻译：

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髋关节和膝关节骨性关节炎患者的关节成形术进展：瑞典 BOA 登记处的一项研究。

目的 本研究的目的是估计髋关节和膝关节骨关节炎 (OA) 患者的关节成形术时间，并确定在一线干预入组时可预测手术进展的因素。方法 在这项基于登记的纵向观察研究中，我们在 2008 年 5 月至 2016 年 12 月期间在骨关节炎患者更好管理登记 (BOA) 中确定了 72,069 名髋关节和膝关节 OA 患者，这些患者被转诊进行一线 OA 干预。随访至 2016 年 12 月 31 日之前的第一次初次关节置换手术，分层为髋关节和膝关节 OA 队列。使用 Kaplan-Meier 和多变量调整的 Cox 回归分析数据。结果 五年时，Kaplan-Meier 估计显示，46%（95% 置信区间 (CI) 44.6 至 46.9）髋关节 OA 患者，20%（95% CI 19.7 至 21.0）的膝关节 OA 患者进展为关节置换术。最强的预后因素是手术意愿（风险比（HR）髋关节 3.12（95% CI 2.95 至 3.31），膝关节 HR 2.72（95% CI 2.55 至 2.90）），行走困难（髋关节 HR 2.20（95% CI 1.97 至2.46），HR 膝关节 1.95（95% CI 1.73 至 2.20））和频繁疼痛（HR 髋关节 1.56（95% CI 1.40 至 1.73），HR 膝关节 1.77（95% CI 1.58 至 2.00））。在髋关节 OA 中，合并症患者进展至手术的概率较低（例如，≥ 4 种情况；HR 0.64（95% CI 0.59 至 0.69）），在膝关节 OA 队列中没有可检测到的影响。相反，超重或肥胖增加了膝关节队列中 OA 进展的可能性（HR 1.25（95% CI 1.15 至 1.37）），但在髋关节 OA 中没有。结论 与膝关节 OA 患者相比，髋关节 OA 患者的关节置换术进展更快且程度更大。进展受患者对手术的渴望和与 OA 症状严重程度相关的因素的强烈影响，但与 OA 症状不直接相关的因素也很重要。然而，很大一部分 OA 患者似乎在 5 年内不需要手术，尤其是膝关节 OA 患者。引用这篇文章：骨关节 J 2022;104-B(7):792-800。特别是在膝关节骨关节炎患者中。引用这篇文章：骨关节 J 2022;104-B(7):792-800。特别是在膝关节骨关节炎患者中。引用这篇文章：骨关节 J 2022;104-B(7):792-800。