ECE2024 Poster Presentations Late-Breaking (77 abstracts)
The prevalence of joint replacement surgery in patients with acromegaly
Sophie Hebden 1 , Megan Heague 1 , Julie Lynch 2 , Nawaz Z Safdar 2 , David McLaren 2,3 , Alberto Stefano Tresoldi 4,5,6 , Kirstie Lithgow 4,5,6 , Sandrine Urwyler 4,5,6 , Chetna Varsani 7 , Shahzad Akbar 8 , Katie McLoughlin 9 , Katarzyna Adeniji 9 , Tara Kearney 9 , Thozhukat Sathyapalan 8 , Claire Higham 10 , William Drake 7 , Niki Karavitaki 4,5,6 , Robert D Murray 2,3 & Nikolaos Kyriakakis 2
1University of Leeds, School of Medicine, Leeds, United Kingdom; 2Leeds Teaching Hospitals NHS Trust, Department of Endocrinology, Leeds, United Kingdom; 3University of Leeds, Leeds Institute of Cardiovascular and Metabolic Medicine (LICAMM), Leeds, United Kingdom; 4University of Birmingham, Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, Birmingham, United Kingdom; 5Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, United Kingdom; 6University Hospitals Birmingham NHS Foundation Trust, Department of Endocrinology, Queen Elizabeth Hospital, Birmingham, United Kingdom; 7Barts Health NHS Trust, Department of Endocrinology, St Bartholomew’s Hospital, London, United Kingdom; 8Hull University Teaching Hospitals NHS Trust, Department of Academic Diabetes and Endocrinology, Hull, United Kingdom; 9Salford Royal NHS Foundation Trust, Department of Endocrinology, Salford, United Kingdom; 10The Christie NHS Foundation Trust, Department of Endocrinology, Manchester, United Kingdom
Background: Patients with acromegaly experience early onset arthropathy characterised by initial joint space widening due to cartilage hyperplasia, with later degenerative changes characterised by joint space narrowing, sclerosis and osteophyte formation. To date no specific treatment is available for the arthropathy these patients experience, with management being limited to analgesics, anti-inflammatory agents, physiotherapy, joint injections, and potentially joint replacement surgery in the latter stages. We evaluated the prevalence of joint replacement surgery in a large population of patients with acromegaly.
Methods: Patients with a diagnosis of acromegaly under follow-up in six tertiary pituitary centres were invited to complete a questionnaire relating to joint pain and distribution; and impact on function and QoL. As part of the ‘Medication Use’ questionnaire, patients were asked to complete data relating joint replacement surgery.
Results: 411 patients completed the questionnaires, median age 60 (range 18-88) yrs, 56.1% female and mean age at diagnosis 43 (range 12-83) yrs, with duration of disease 13 (IQR 5.9-20.9) years. Of the cohort 70 (17.4%) patients had undergone joint replacement, equating to a total of 130 episodes of joint replacement surgery. The median number of joints replaced was 2 (range 1–6). The most frequent joints replaced were the hip in 49 patients (70 joint replacements), knee in 30 (42 joint replacements), and shoulder in 9 (15 joint replacements). The median age at the time of joint replacement surgery was 59.0 (IQR 51.8-70.0) years. The median age in those with joint replacement at the time of questionnaire completion was 65.9 (IQR 56.4-73.0) years and 58 (IQR 47.9-68) years in those without joint replacement. Patients with joint replacements had a greater number of painful joints than those without joint replacements (5, IQR 3-7 Vs 3, IQR 1-6; P=0.002). There was no difference in the proportion of patients with active acromegaly between those who had and had not had joint replacement (38.8% Vs. 35.7%; P=0.73), however duration of disease was longer (17.0, IQR 8.2-24.3 Vs. 13.0, IQR 5.9-20.9; P=0.024) years. In addition to replacement joints, 70 patients had undergone other surgical joint interventions to the knees (n=22), spine (n=16), wrist (n=12), hallux (n=9), shoulder (n=6), elbow (n=6), ankle/foot (n=4) and hip (n=3).
Conclusions: Patients with a history of acromegaly have a significant risk of requiring joint surgery or replacement with correlates with higher number of joints affected, age and duration of disease.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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