Differences between patients with hip and knee osteoarthritis

s / Osteoarthritis and Cartilage 21 (2013) S63–S312 S139 plus meniscal injury and osteochondral fracture as visualized on baseline MR images. Results: The mean age of the participants was 26 years, 27% were female and the mean BMI was 24kg/m2. Over the course of 5 years the change in curvature was statistically significant in each region of the knee. In each region the values for curvature decreased (Figure). Participants randomized to early surgery as opposed to rehabilitation plus optional delayed ACL reconstruction were more likely to have flatter curvature in the femur (P<.001), medial femoral condyle (p1⁄40.006) and trochlea (p1⁄40.003). Any meniscal injury (largely medial meniscus) was associated with a more flattened curvature in the femur (p1⁄40.001), trochlea (p1⁄40.011) and lateral femoral condyle (p1⁄40.038) and lateral tibia (p1⁄40.048). In contrast, a lateral tibial osteochondral fracture was associated with amore convex curvature in the lateral tibia (p1⁄40.017). Conclusions: This study demonstrates that ACL injury leads to significant changes in articulating bone curvatures. These changes are measurable within a short interval (3 months) of the injury. Increased body mass index, meniscal injury and randomization to surgery (as distinct from rehabilitation plus optional delayed ACL reconstruction) all lead to decreased curvature. Figure. Trajectory of bone curvature (1/mm, inverse millimeters) change over the five year follow-up period by aratomic location. 255 DIFFERENCES BETWEEN PATIENTS WITH HIP AND KNEE OSTEOARTHRITIS K.F. Le Marshall y, B. Yee z, P.A. Dieppe z, A. Leung y, C. Page x, P.F. Choong x, M. Dowsey x, K.K. Lim y. yWestern Hlth., Footscray, Australia; z Penninsula Coll. of Med. & Dentistry, Plymouth, United Kingdom; x St Vincent's Hosp., Melbourne, Australia Purpose: This observational study was designed to examine the hypothesis that patients with hip osteoarthritis (OA) have a shorter duration of symptoms but more advanced radiological changes and more severe symptoms at first presentation to our clinic than similar patients with knee OA. Methods: This case-comparison study compared 35 consecutive hip OA patients and 70 (age and sex matched) knee OA patients from a single tertiary osteoarthritis clinic from 2008 to 2011. BMI, total symptom duration, duration of presenting complaint, Multi-attribute Arthritis Prioritisation Tool (MAPT) scores and Modified Kellgren-Lawrence (MKL) scores were recorded for each patient's first presentation to the clinic. The MAPT score, designed to prioritise and monitor patients who may require joint surgery, is a severity score (out of a total of 100) derived from a standardised patient questionnaire. MKL scores were converted to ordinal data for statistical analysis. Data for the hip and knee groups was compared by non-parametric Mann-Whitney U testing, performed by a statistician who was blinded to the study hypothesis. Results: Both groups had similar age, sex and BMI. The hip MAPT score (median 1⁄4 71.3, interquartile range 37.9 89.6) was significantly higher than the knee MAPT score (median 1⁄4 36.9, IQR 11.4 74.8); mean rank for hip group was 64.8 and mean rank for knee group was 47.1 (U 1⁄4 1638, p 1⁄4 0.005). The hip MKL scores (median 1⁄4 4, IQR 4 5) were significantly higher than the knee MKL scores (median 4, IQR 3 4); mean rank for hip group was 65.7 and mean rank for knee group was 46.7 (U1⁄4 1669.5, p1⁄4 0.002). The total duration of symptoms for the hip group (median 1⁄4 30, IQR 12 54 months) was significantly less than the duration of symptom for the knee group (median 1⁄4 48, IQR 24 108 months); mean rank for hip group was 33.6 and mean rank for knee group was 44.1 (U 1⁄4 545.5, p 1⁄4 0.045). The duration of presenting complaint for the hip group (median 1⁄4 6, IQR 3.0 6.5 months) was significantly less than the duration of presenting complaint for the knee group (median 1⁄4 9.5, IQR 5.5 12.0 months); mean rank for hip group was 32.1 and mean rank for knee group was 45.1 (U 1⁄4 500, p 1⁄4 0.012). Conclusions: In this case-comparison study, patients with hip OA presented after a shorter duration of symptoms with higher MAPT and MKL scores than their knee OA counterparts. In other words, hip OA patients were more likely to present earlier to our clinic but were conversely more likely to have more advanced radiological changes and worse symptoms (byMAPT score) than knee OA patients. These findings support our hypothesis and warrant a larger observational study. 256 CONSTRUCT VALIDITY OF PROMIS INSTRUMENTS AMONG PATIENTS WITH SYMPTOMATIC KNEE OSTEOARTHRITIS N.L. Morgan, J.B. Driban, G.L. Ransford, L. Price, C. Wang. Tufts Med. Ctr.,