Predicting OA progression to total hip replacement: Can we do better than risk factors alone using active shape modelling as an imaging biomarker?

Rebecca J. Barr (Lead / Corresponding author), Jennifer S. Gregory, David M. Reid, Richard M. Aspden, Kanako Yoshida, Gillian Hosie, Alan J. Silman, Salvatore Alesci, Gary J. Macfarlane

Research output: Contribution to journalArticlepeer-review

47 Citations (Scopus)


Objective. Previously, active shape modelling (ASM) of the proximal femur was shown to identify those individuals at highest risk of developing radiographic OA. Here we determine whether ASM predicts the need for total hip replacement (THR) independent of Kellgren-Lawrence grade (KLG) and other known risk factors.Methods. A retrospective cohort study of 141 subjects consulting primary care with new hip pain was conducted. Pelvic radiographs taken on recruitment were assessed for KLG, centre-edge angle, acetabular depth and femoral head migration. Clinical factors (duration of pain, use of a stick and physical function) were collected by self-completed questionnaires. ASM differences between shape mode scores at baseline for individuals who underwent THR during the 5-year follow-up (n = 27) and those whose OA did not progress radiographically (n = 75) were compared. Results. A 1 s.d. reduction in baseline ASM mode 2 score was associated with an 81% reduction in odds of THR (OR = 0.19, 95% CI 0.52, 0.70) after adjustment for KLG, radiographic and clinical factors. A similar reduction in odds of THR was associated with a 1 s.d. reduction in mode 3 (OR = 0.45, 95% CI 0.28, 0.71) and a 1 s.d. increase in mode 4 score (OR = 2.8, 95% CI 1.7, 4.7), although these associations were no longer significant after adjustment for KLG and clinical factors.Conclusion. ASM of the hip joint is a reliable early biomarker of radiographic OA severity, which can improve the ability to identify patients at higher risk of rapid progression and poor outcome even when KLG and clinical risk factors are taken into account.

Original languageEnglish
Article numberker382
Pages (from-to)562-570
Number of pages9
Issue number3
Early online date2 Dec 2011
Publication statusPublished - Mar 2012


  • Active shape modelling
  • Biomarker
  • Osteoarthritis
  • Total hip replacement

ASJC Scopus subject areas

  • Rheumatology
  • Pharmacology (medical)


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