Active shape modelling compared to hip morphometry in the prediction of hip fracture - Thesis Example

This project aims to examine the relationship between the shape of the hip joint and total hip replacement in osteoarthritis,a severe illness with significant psychological and social repercussions.OA is the most common form of arthritis and it affects the connective tissues around the joints, particularly bone and cartilage. The cartilage covering the bone tips at the joints is an important cushion protecting the bone from friction during motion and allowing for smooth interactions of adjacent bones in the joint space.

Degradation of cartilage during OA leads to comparative exposure of the bone, causing frictional resistance between bones during joint movement. Thus pain, stiffness, swelling and inflammation result making day to day activities difficult. Added to this deformation of normal joint shape, bone spurs (osteophytes) growing at the tips of bones, which sometimes detach and may be found loose in the joint space worsen the pain. In contrast to the other common form of arthritis i.e. rheumatoid arthritis (RA); OA affects only the joints and its affect on joints is often asymmetrical, i.e. not both joints are simultaneously affected.

Besides OA is a degenerative disease, associated with elderly, and affecting the young less than RA. The joints affected by OA are mainly knees, hips, hands (finger and thumb), and spine (neck and Lower back) (figure 1-1). Recent data indicate that 46 million Americans above the age of 25 are affected by OA, while the WHO data estimates declare the population affected by OA to be 10% of the world population (Symmons et al., 2006). As the population ages, the global burden of this disease is bound to increase (figure 1-2).

An estimated 67 million individuals are expected to exhibit clinical symptoms of OA by the year 2030 (Hootman & Helmick, 2006). Besides this individuals affected with diabetes or cardiovascular diseases are usually affected by OA, as reported in 50% of such cases (CDC, 2008a). OA is the fourth leading cause of disease burden in the non fatal category and accounts for % of the global total years lived with disability (YLD); which is equivalent to YLD for schizophrenia and congenital diseases (Reginster 2002).

As a result approximately $81 billion are spent every year on OA treatment. However estimation of incidences of OA occurrence is difficult because of the precise definition of the disease available and the wide range of symptoms associated withOA. Figure 1-2 Projected number of adults with arthritis (Hootman and Helmick, 2006) Specific diagnostic symptoms of OA being considered in the estimation of prevalence being: Occurrence of pain in joints for more than half the days of a month Radiographic evidences of OA.

On the basis of these criteria current prevalence of OA in America is 27.2 million people (Lawrence et al., 2008); and 72 million individuals who would have reached the age of 65 by 2030 will be vulnerable to the disease (NIAMS, 2006) (figure 1 -3). Figure 1-3 Projected number of US adults men and women (CDC, 2007) OA increasingly affects individuals above the age of 65, with peak age of diagnosis being ?85 for women and 75-84 for men (Hamerman 1995) (figure 1-4). It has physical, psychological and social impacts on routine life, causing pain, inability to perform routine activities and depression (Stein et al., 2006). OA prevalence is also determined by the racial or geographic differences.

Afro-American females are at higher risk of knee OA than Caucasian Females, but this not the case for hip OA (Anderson & Felson, 1988). Hip OA on the other hand is less prevalent in Jamaican black females than Afro Americans (Bremner et al., 1968). It is also less common in African black (Solomon et al., 1976), and Chinese (Hoaglund et al., 1973) (table 1). Table A-1: Prevalence of hip OA in reference to Geographic locations REGION REFERENCE DIAGNOSTIC CRITERIA PREV. RATE (45+ INDIVIDUALS /1000,000) M F AFRO Soloman et al.

, 1975 Soloman et al., 1976. Clinical diagnosis based on K-L grading Radiographic