Homo 72/3 (2021), 183–203 Article J. Comp. Hum. Biol. Published online 23 June 2021, published in print September 2021 © 2021 E. Schweizerbart’sche Verlagsbuchhandlung, 70176 Stuttgart, Germany www.schweizerbart.de DOI: 10.1127/homo/2021/1329 0018-442X/2021/1329 $ 5.25 The effects of orthopedic pathological conditions and systemic diseases on the prevalence of hip osteoarthritis in Modern African- and European-Americans Aubrie Sanchez 1,2, *, Sean D. Tallman 1,3 , Allysha P. Winburn 4 , Joshua Stefanik 5 1 Department of Anatomy & Neurobiology, Boston University School of Medicine, Boston, MA, USA 2 School of Health and Rehabilitation Sciences, The Ohio State University, 333 W. 10 th Avenue, 2063 Graves Hall, Columbus, OH 43210, USA 3 Department of Anthropology, Boston University, Boston, MA, USA 4 Department of Anthropology, University of West Florida, Pensacola, FL, USA 5 Department of Physical Therapy, Movement & Rehabilitation Sciences, Northeastern University, Boston, MA, USA * Corresponding author: aubrie.sanchez@osumc.edu With 11 fgures and 4 tables Abstract: Osteoarthritis (OA) is a leading cause of disability among aging adults. In the U.S., many individuals living with total hip replacements attribute OA as the cause. However, the majority of anthropological OA research excludes pathologi- cal individuals (i.e., individuals with systemic disease, traumatic injuries, or orthopedic devices). Thus, little is known about how implants and pathological conditions impact OA beyond a general acceptance that they likely increase OA risk. This study adds to the skeletal research surrounding OA by directly investigating its relationship with age, disease, and implants. The proximal femora of 186 African- and European-American individuals (21–95 years old) from the Edmonds Orthopedic Pathology Collection (National Museum of Health and Medicine; Armed Forces Institute of Pathology) were analyzed. The individuals were grouped into three cohorts: disease; non-disease; and previous injury/implant. Jurmain’s (1990) ordinal scoring method was used to categorize OA changes as: none/slight; moderate; severe; and ankylosis. Intra- rater reliability for the scoring of OA was perfect, while inter-rater reliability was moderate. Results from Chi-square tests, exploratory data analysis, and ordinal logistic regression showed that there was a statistically signifcant relationship (p < 0.001) between degree of OA, age, recorded disease (e.g., cancer), and evidence of previous injury (i.e., healed fractures, fracture fxation devices). In contrast with the expectation that diferent populations exhibit diferent patterns of OA, no signifcant sex or ancestry efects were observed. These results help researchers better understand the etiology and contem- porary risk factors of OA as well as identifying an additional subset of the population who may be at greater risk for devel- oping OA – i.e., individuals with fractures, implants, and systemic disease, especially those in older age cohorts (60+ years). Keywords: degenerative joint disease; orthopedic implant; arthroplasty; ancestry; skeletal biology Introduction The current research explores the relationships between orthopedic pathological conditions of the proximal femur (i.e., implants and surgical pins or total hip arthroplasties), disease (e.g., metastatic cancer), and the expression of osteo- arthritis (OA) of the hip joint and investigates the efects of age, sex, and ancestral group on hip OA. As a degenera- tive joint disease, OA is estimated to be one of the leading causes of disability in the U.S. (Racine 2015) and the fourth leading cause of disability worldwide (Fransen et al. 2011; Zampetti et al. 2016). In the U.S., over 2.5 million individu- als live with total hip arthroplasties (Maradit Kremers et al. 2015), of which 70% attribute OA as the cause (AJRR 2016). Lawrence et al. (1998) projected that nearly 20% of the U.S. population, or approximately 60 million individuals, would be diagnosed with a musculoskeletal disease by the end of 2020. Additionally, the National Institutes of Health’s Genetic and Rare Diseases Information Center lists over 650 musculoskeletal diseases, which include, but are not limited to: fracture; dysplasia; rickets; arthritis; and gout (https:// rarediseases.info.nih.gov/diseases/diseases-by-category/15/ musculoskeletal-diseases). Since OA generally does not occur in isolation and is often afected by factors like obe- sity or trauma, it is important to understand the relationship between osteoarthritic changes and pathological conditions.