The mean age was 80.1 years in both groups (
p = 0.97). There were 253 (72%) women among the cases and 80 (71%) in the control group (
p = 0.83). In the case group, there were 172 patients (49%) with a trochanteric fracture and 177 (51%) with a femoral neck fracture. When using both grading systems combined, 48/250 (19%) patients with hip fractures and 21/112 (19%) patients with hip contusions had OA at the injured side (Table
1,
p = 0.92). At the non-injured side, we found that 61/349 (18%) had OA in the patients with hip fractures compared to 8/110 (7%) in the hip contusion group using both classifications combined (Table
1,
p = 0.01). The same pattern was found using K&L grading and MJS, separately (Table
1). In a subgroup analysis comparing the two fracture types, there was 14/96 (15%) with OA in the femoral neck group and 34/154 (22%) in the trochanteric group (Table
2,
p = 0.14). Similar results were found on the non-injured side (Table
2). We also compared each fracture separately with the controls for the presence of OA and found on the injured side that there was no difference between cases and controls. Overall, OA for femoral neck fractures was 14/96 (15%) and for controls 21/112 (19%). This gave a relative risk of OA of 0.78 (95% CI, 0.42 to 1.44,
p = 0.42) for the fracture group compared with the control group. Comparing the trochanteric fractures with a rate of OA of 34/154 (22%) to the controls (19%) gave a relative risk (RR) of OA of 1.18 (95% CI, 0.72 to 1.92,
p = 0.51). For the non-injured side for the cases with femoral neck fractures, the rate of OA was 26/177 (15%) compared to 8/110 (7%) for the controls, giving a RR of OA of 2.02 (95% CI, 0.95 to 4.30,
p = 0.06), and for the trochanteric fractures the rate of OA was 35/172 (20%) giving a RR for OA of 2.80 (1.35 to 5.80,
p = 0.003) compared to the controls. The mean MJS was 0.1 mm smaller in the femoral neck fracture patients than controls (95% CI, −0.34 to 0.10;
p = 0.27), and for the trochanteric fracture patients, MJS was 0.3 mm narrower (95% CI, −0.05 to −0.49;
p = 0.02) compared to the controls.
Table 1
Osteoarthritis measured by MJS and/or K&L in the hip fracture group compared with the hip contusion group
MJS ≤2.5 mm ipsilateral (n, %) | 31/250 (12%) | 16/112 (14%) | 0.87 (0.50 to 1.52) | 0.62 |
K&L grade II or higher ipsilateral (n, %) | 40/250 (16%) | 20/112 (18%) | 0.90 (0.55 to 1.46) | 0.66 |
Osteoarthritisa ipsilateral (n, %) | 48/250 (19%) | 21/112 (19%) | 1.02 (0.65 to 1.63) | 0.92 |
MJS ipsilateral (mean, SD) | 3.54 (0.99) | 3.51 (1.00) | 0.03 (−0.19 to 0.25) | 0.79 |
MJS ≤2.5 mm contralateral (n, %) | 42/349 (12%) | 8/110 (7%) | 1.66 (0.80 to 3.41) | 0.16 |
K&L grade II or higher contralateral (n, %) | 52/349 (15%) | 8/110 (7%) | 2.05 (1.00 to 4.18) | 0.04 |
Osteoarthritisa contralateral (n, %) | 61/349 (18%) | 8/110 (7%) | 2.40 (1.19 to 4.87) | 0.01 |
MJS contralateral (mean, SD) | 3.55 (0.95) | 3.74 (0.87) | −0.20 (−0.39 to 0.00) | 0.06 |
Table 2
Osteoarthritis measured by MJS and/or K&L in the case group comparing femoral neck fractures and trochanteric fractures
MJS ≤2.5 mm ipsilateral (n, %) | 8/96 (8%) | 23/154 (15%) | 0.56 (0.26 to 1.19) | 0.12 |
K&L grade II or higher ipsilateral (n, %) | 10/96 (10%) | 30/154 (20%) | 0.54 (0.27 to 1.04) | 0.06 |
Osteoarthritisa ipsilateral (n, %) | 14/96 (15%) | 34/154 (22%) | 0.66 (0.37 to 1.17) | 0.14 |
MJS ipsilateral (mean, SD) | 3.72 (0.90) | 3.42 (1.03) | 0.30 (0.05 to 0.55) | 0.02 |
MJS ≤2.5 contralateral, mm (n,%) | 15/177 (9%) | 27/172 (16%) | 0.54 (0.30 to 0.98) | 0.04 |
K&L grade II or higher contralateral (n, %) | 25/177 (14%) | 27/172 (16%) | 0.90 (0.55 to 1.49) | 0.68 |
Osteoarthritisa contralateral (n, %) | 26/177 (15%) | 35/172 (20%) | 0.72 (0.46 to 1.15) | 0.16 |
MJS contralateral (mean, SD) | 3.62 (0.97) | 3.47 (0.91) | 0.14 (−0.06 to 0.34) | 0.16 |
When comparing OA as defined by MJS and K&L, the Pearson correlation coefficient was r = 0.67 (p < 0.01) on the injured side and r = 0.72 (p < 0.001) on the non-injured side. The Pearson correlation coefficient of the overall OA between the injured and non-injured side was 0.24 (p < 0.001). Six patients in the fracture group, all with trochanteric fractures, and five patients in the contusion group, had bilateral osteoarthritis. Three patients in the contusion group had osteoarthritis only on the non-injured side.