Relationship Between Hip Dysplasia, Pain, and Osteoarthritis in a Cohort of Patients with Hip Symptoms

2013 ◽  
Vol 40 (9) ◽  
pp. 1583-1589 ◽  
Author(s):  
Johanne Morvan ◽  
Ronan Bouttier ◽  
Bernard Mazieres ◽  
Evelyne Verrouil ◽  
Jacques Pouchot ◽  
...  
Keyword(s):  
Anterior Margin ◽  
Hip Dysplasia ◽  
Acetabular Dysplasia ◽  
Hip Osteoarthritis ◽  
Population Based ◽  
Hip Pain ◽  
Prevalence Survey ◽  
Center Edge ◽  
Study Participants ◽  
The Relationship

Objective.The relationship between acetabular dysplasia (HD) and hip osteoarthritis (OA) remains unclear, especially for mild forms of dysplasia. Our objectives were to estimate the prevalence of HD in a population-based sample with symptoms and to evaluate potential associations linking HD, hip OA, and hip pain.Methods.Individuals 40 to 75 years of age with symptoms in 1 or both hips were recruited during a multiregional prevalence survey. All study participants underwent examination and radiographs. Radiographs were evaluated using Kellgren-Lawrence staging (with stages ≥ 2 indicating hip OA) and HD measures [center-edge (CE) angle, acetabular inclination angle (HTE), acetabular depth (AD), and vertical center-anterior margin angle].Results.We studied both hips of 842 individuals (1684 hips), among whom 203 had hip OA. Compared to left hips, right hips had significantly smaller CE angles and significantly greater AD and HTE values (p ≤ 0.001). Overall, the prevalence of HD ranged from 7.6% to 22.2% of the hips depending on the measure used. The prevalence of HD was higher in individuals with hip OA, with significant differences for abnormal HTE (19.1% vs 11.4%; p < 0.0001) and abnormal CE (11.3% vs 7.5%; p = 0.04). By logistic regression, only abnormal HTE remained associated with OA. Same-side hip pain was not statistically more common in individuals with HD after stratification on OA status (p = 0.12).Conclusion.Our study confirms the relationship between OA and HD, particularly as defined based on the HTE angle.

The association of lumbosacral transitional vertebral anomalies with acetabular dysplasia in adult patients with hip-spine syndrome

2021 ◽  
Vol 103-B (8) ◽  
pp. 1351-1357
Author(s):  
Joshua Sun ◽  
Avneesh Chhabra ◽  
Uma Thakur ◽  
Louis Vazquez ◽  
Yin Xi ◽  
...  
Keyword(s):  
Acetabular Dysplasia ◽  
Intraclass Correlation ◽  
Final Diagnosis ◽  
Hip Pain ◽  
Pars Interarticularis ◽  
Vertebral Anomalies ◽  
Lumbosacral Transitional Vertebra ◽  
Standard Radiographs ◽  
Time Of Presentation ◽  
The Relationship

Aims Some patients presenting with hip pain and instability and underlying acetabular dysplasia (AD) do not experience resolution of symptoms after surgical management. Hip-spine syndrome is a possible underlying cause. We hypothesized that there is a higher frequency of radiological spine anomalies in patients with AD. We also assessed the relationship between radiological severity of AD and frequency of spine anomalies. Methods In a retrospective analysis of registry data, 122 hips in 122 patients who presented with hip pain and and a final diagnosis of AD were studied. Two observers analyzed hip and spine variables using standard radiographs to assess AD. The frequency of lumbosacral transitional vertebra (LSTV), along with associated Castellvi grade, pars interarticularis defect, and spinal morphological measurements were recorded and correlated with radiological severity of AD. Results Out of 122 patients, 110 (90.2%) were female and 12 (9.8%) were male. We analyzed the radiographs of 122 hips (59 (48.4%) symptomatic left hips, and 63 (51.6%) symptomatic right hips). Average age at time of presentation was 34.2 years (SD 11.2). Frequency of LSTV was high (39% to 43%), compared to historic records from the general population, with Castellvi type 3b being the most common (60% to 63%). Patients with AD have increased L4 and L5 interpedicular distance compared to published values. Frequency of pars interarticularis defect was 4%. Intraclass correlation coefficient for hip and spine variables assessed ranged from good (0.60 to 0.75) to excellent (0.75 to 1.00). Severity of AD did not demonstrate significant correlation with frequency of radiological spine anomalies. Conclusion Patients with AD have increased frequency of spinal anomalies seen on standard hip radiographs. However, there exists no correlation between radiological severity of AD and frequency of spine anomalies. In managing AD patients, clinicians should also assess spinal anomalies that are easily found on standard hip radiographs. Cite this article: Bone Joint J 2021;103-B(8):1351–1357.

scholarly journals Comparison of four parameters to assess acetabular dysplasia and acetabular dysplasia rates in primary hip osteoarthritis patients: A study in Turkish population

2018 ◽  
Vol 26 (2) ◽  
pp. 230949901876803 ◽  
Author(s):  
Oktay Adanir ◽  
Gazi Zorer
Keyword(s):  
Femoral Head ◽  
Acetabular Dysplasia ◽  
Hip Prosthesis ◽  
Hip Osteoarthritis ◽  
High Rate ◽  
Femoral Head Coverage ◽  
Coverage Ratio ◽  
Total Hip ◽  
Center Edge ◽  
Age At Surgery

Introduction: Hip osteoarthritis is an important orthopedic problem frequently observed in the elderly. Acetabular dysplasia (AD) is one of the pathologies that cause coxarthrosis. Nearly 20–45% of primary or idiopathic hip osteoarthritis is linked to AD. In our country, there are few studies on this topic. We measured the center–edge (CE) angle, Sharp’s angle, acetabular depth, and femoral head coverage ratio on pelvis anteroposterior radiographs of patients with primary coxarthrosis and calculated the dysplasia rates. Patients and method: Age at surgery and sex of the patients; and CE angle, Sharp’s angle, acetabular depth, and femoral head coverage ratio for both operated and opposite hips were evaluated in 223 total hip prosthesis–performed patients with coxarthrosis. Also the distribution of mean age at surgery, sex of patients, dysplasia rates of operated hips, and bilateral dysplasia rates were calculated. Results: The right to left ratio of operated hips was 104/119. Female to male ratio was 163/60 (2.7/1), for those with CE angle below 20° it was 123/30 (4.1/1), and it was 40/30 (1.3/1) with CE angle above 20°. Mean age of patients at surgery was 56.9 (±11.4) years. CE angle less than 20° was found in 68.6% of patients, acetabulum depth less than 9 mm was found in 75.3%, Sharp’s angle was more than 45° in 65.9%, and femoral head coverage ratio was less than 70% in 70.3% of patients. Conclusions: We identified a high rate of AD in primary coxarthrosis patients undergoing total hip arthroplasty in the study population.

MECHANICAL STRESS MAY CAUSE THE TEAR OF THE LABRUM IN ACETABULAR DYSPLASIA

2004 ◽  
Vol 08 (01) ◽  
pp. 35-41
Author(s):  
Hirotaka Sano ◽  
Norikazu Yamada ◽  
Shingo Maeda
Keyword(s):  
Stress Concentration ◽  
Mechanical Stress ◽  
Acetabular Dysplasia ◽  
The Body ◽  
Von Mises Stress ◽  
Center Edge ◽  
Dimensional Finite Element ◽  
Von Mises ◽  
Distal Border ◽  
The Relationship

In the current study, using the arthrogram, we developed two-dimensional finite element (FE) models of the human hip joint. To clarify the relationship between the stress distribution and the degree of acetabular dysplasia, three FE models were established and analyzed. The models varied only in the degree of the bony covering of the femoral head; i.e. the center-edge (CE) angle=20, 10, 0 degrees. An edge load (x=0 N, y=600 N) was then applied on the distal border of the femur to simulate the bearing of the body weight. In the CE=20 degree model, no definite stress concentration was seen at the site of the labrum. On the other hand, the stress concentration was seen from the attachment of the labrum to the superior aspect of the acetabulum in the CE=0 degree model. The site of stress concentration clearly corresponded to the lesions where the acetabular rim pathologies were seen in the clinical practice. Moreover, we found that the Von Mises stress increases dramatically with decreasing the CE angle at the attachment of the labrum. In the dysplastic hip, the mechanical stress increases significantly at the supero-lateral aspect of the acetabulum, which eventually leads to the tearing or detachment of the labrum.

scholarly journals Outcomes of periacetabular osteotomy for borderline hip dysplasia in adolescent patients

2020 ◽  
Vol 7 (2) ◽  
pp. 249-255
Author(s):  
Ishaan Swarup ◽  
Ira Zaltz ◽  
Stacy Robustelli ◽  
Ernest Sink
Keyword(s):  
Hip Arthroscopy ◽  
Acetabular Dysplasia ◽  
Periacetabular Osteotomy ◽  
Hip Pain ◽  
Center Edge ◽  
Outcome Scores ◽  
Adolescent Patients ◽  
History Of ◽  
Outcome Tool

Abstract Treatment of borderline acetabular dysplasia (lateral center edge angle ≥18°) remains controversial, and there is a paucity of literature focusing on outcomes in adolescent patients. The purpose of this study was to evaluate the outcomes of a periacetabular osteotomy (PAO) as surgical management of borderline acetabular dysplasia in adolescent patients. We performed a retrospective review of prospectively collected data and included patients ≤ 21 years of age that underwent PAO for borderline acetabular dysplasia. All patients had a minimum of 1-year follow-up. Outcomes were assessed using modified Harris Hip Scores (mHHS), Hip Outcome Scores (HOS) and international Hip Outcome Tool (iHOT-33). Descriptive and univariate statistical analyses were performed. This study included 33 adolescent patients (35 hips) with symptomatic, borderline acetabular dysplasia. The majority of patients was female (32 patients, 97%); half of all patients reported a history of hip pain for over 1 year; and seven patients had previous hip arthroscopy. In addition to PAO, seven hips (20%) underwent a concurrent hip arthroscopy at the time of surgery. There were significant improvements in mean mHHS, HOS-activities of daily living (ADL), HOS-Sport and iHOT-33 scores after surgery (P &lt; 0.01). Minimal clinically important difference in outcome scores was achieved for over 90% of patients at a minimum of 1-year follow-up. Borderline acetabular dysplasia is a major cause of hip pain in adolescent patients. Patients with symptomatic borderline acetabular dysplasia report a significant benefit after a PAO to correct structural hip instability.

scholarly journals Prevalence and associated factors of pistol grip deformity in Japanese local residents

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Takaya Taniguchi ◽  
Teiji Harada ◽  
Toshiko Iidaka ◽  
Hiroshi Hashizume ◽  
Wataru Taniguchi ◽  
...  
Keyword(s):  
Multiple Logistic Regression Analysis ◽  
Joint Space Width ◽  
Joint Space ◽  
Population Based ◽  
Hip Pain ◽  
Japanese People ◽  
Entire Cohort ◽  
Explanatory Variables ◽  
Pelvic Parameters ◽  
Center Edge

AbstractPistol grip deformity (PGD) may be the main factor in femoroacetabular impingement development. This study aimed to clarify the epidemiological indices and factors related to PGD in Japanese people. This population-based cohort study included 1575 local Japanese residents. PGD, center edge angle, and joint space width were measured radiographically. We investigated the relationship between PGD and spino-pelvic parameters. Factors associated with PGD were examined using multiple logistic regression analysis, with the presence/absence of PGD as an objective variable, and sex, age, body mass index (BMI), and the presence/absence of hip pain or spino-pelvic parameters as explanatory variables. In the entire cohort, 4.9% (10.6% men, 2.1% women) had PGD on at least one side. A trend was observed between PGD and increasing age in both men and women (men: p < 0.0001, women: p = 0.0004). No relationship was observed between PGD and hip pain (risk ratio 1.0 [95% confidence interval 0.97–1.03]). Factors significantly associated with PGD were age, sex, and BMI in the multivariate model. Acquired factors may be related to PGD in Japanese people as the PGD prevalence increased with age and PGD was not significantly associated with hip pain. This study provides new insights into the etiology and clinical significance of PGD.

scholarly journals Osteophyte size and location on hip DXA scans are associated with hip pain: findings from a cross sectional study in UK Biobank

2021 ◽  
Author(s):  
Benjamin G Faber ◽  
Raja Ebsim ◽  
Fiona R Saunders ◽  
Monika Frysz ◽  
Claudia Lindner ◽  
...  
Keyword(s):  
Femoral Head ◽  
Joint Space Width ◽  
Hip Osteoarthritis ◽  
Joint Space ◽  
Cross Sectional Study ◽  
Hip Pain ◽  
Uk Biobank ◽  
Cross Sectional ◽  
Automated Method ◽  
The Relationship

Objective It remains unclear how the different features of radiographic hip osteoarthritis (rHOA) contribute to hip pain. We examined the relationship between rHOA, including its individual components, and hip pain using a novel dual-energy x-ray absorptiometry (DXA)-based method. Methods Hip DXAs were obtained from UK Biobank. An automated method was developed to obtain minimum joint space width (mJSW) from points placed around the femoral head and acetabulum. Osteophyte areas at the lateral acetabulum, superior and inferior femoral head were derived manually. Semi-quantitative measures of osteophytes and joint space narrowing (JSN) were combined to provide a measure of rHOA. Logistic regression was used to examine the relationships between these variables and hip pain, obtained via questionnaires. Results 6,807 hip DXAs were examined. rHOA was present in 353 [5.2%] individuals and was associated with hip pain [OR 2.07 (95% CI 1.54-2.80)] and hospital diagnosed OA [5.73 (2.89-11.36)]. Total osteophyte area and mJSW were associated with hip pain [1.29 (1.21-1.36), 0.84 (0.77-0.92) respectively] in unadjusted models. After mutually adjusting and adding demographic covariates, total osteophyte area continued to have strong evidence of association with hip pain [1.31 (1.23-1.39)] but mJSW did not [0.95 (0.87-1.04)]. Acetabular, superior and inferior femoral osteophyte areas were all independently associated with hip pain [1.19 (1.13-1.26), 1.22 (1.15-1.29), 1.21 (1.14-1.28) respectively]. Conclusion The relationship between DXA-derived rHOA and prevalent hip pain is explained by osteophyte area rather than mJSW. Osteophytes at different locations showed important, potentially independent, associations with hip pain, possibly reflecting the contribution of distinct biomechanical pathways.

scholarly journals Characterization of version in the dysplastic hip and the need for subsequent femoral derotational osteotomy after periacetabular osteotomy

2020 ◽  
Author(s):  
Andrea M Spiker ◽  
Kara G Fields ◽  
Joseph T Nguyen ◽  
Alexandra C Wong ◽  
Ernest L Sink
Keyword(s):  
Hip Dysplasia ◽  
Periacetabular Osteotomy ◽  
Three Dimensional ◽  
Center Edge ◽  
Derotational Osteotomy ◽  
Patient Reported ◽  
Relationship Of ◽  
The Relationship ◽  
Lateral Center Edge Angle

Abstract Hip dysplasia is a three-dimensional pathomechanical condition that is often more complex than the standard method of measuring lateral center edge angle (CEA) can quantify. Yet there is a paucity of literature examining the differences in version seen between dysplastic and non-dysplastic femoroacetabular impingement (FAI) hips, the relationship of acetabular and femoral version (FV) within dysplastic hips and the contribution of each of these factors to symptoms and outcomes of dysplasia treatment. We sought to describe the acetabular version (AcetV) and FV in dysplastic hips and quantify how these measurements compared with non-dysplastic FAI hips. We also sought to analyze the association of these factors with patient-reported outcomes (PROs) after periacetabular osteotomy (PAO) and determine the need for subsequent femoral derotational osteotomy after PAO. A total of 113 dysplastic patients who underwent PAO (92% female, mean age 24) were compared with 1332 (45% female, mean age 25) non-dysplastic FAI (CEA &gt; 25°) patients. We found that dysplastic hips had a statistically higher AcetV and FV than non-dysplastic FAI hips. There was a very weak correlation between AcetV and FV in dysplastic hips, suggesting that patients with higher AcetV did not necessarily have higher FV. There was no association with AcetV or FV and patient outcomes in our very limited analysis of PROs after PAO, and only 5% of patients with excessive FV (&gt;20°) required subsequent femoral derotational osteotomy, suggesting that in a majority of patients with hip dysplasia, FV may not impact the post-operative clinical course.

The “Outside-In” Lesion of Hip Impingement and the “Inside-Out” Lesion of Hip Dysplasia: Two Distinct Patterns of Acetabular Chondral Injury

2019 ◽  
Vol 47 (12) ◽  
pp. 2978-2984 ◽  
Author(s):  
Matthew J. Kraeutler ◽  
Jesse A. Goodrich ◽  
Matthew J. Fioravanti ◽  
Tigran Garabekyan ◽  
Omer Mei-Dan
Keyword(s):  
Predictive Value ◽  
Hip Arthroscopy ◽  
Hip Dysplasia ◽  
Acetabular Dysplasia ◽  
Cartilage Damage ◽  
Hip Impingement ◽  
Center Edge ◽  
Group 2 ◽  
Inside Out ◽  
Group 1

Background: Femoroacetabular impingement (FAI) and acetabular dysplasia lead to acetabular cartilage damage that commonly results in the chondral flaps seen during hip arthroscopy. Purpose: To compare the acetabular chondral flap morphology seen during hip arthroscopy (“outside-in” vs “inside-out”) with clinical and radiographic parameters underlying FAI and hip dysplasia. Study Design: Cohort study; Level of evidence, 3. Methods: Patients who underwent hip arthroscopy by the senior author between 2013 and 2017 with a finding of Outerbridge grade IV acetabular chondral flap were included. Each procedure was retrospectively reviewed on video and chondral flaps were categorized as inside-out or outside-in. An inside-out designation was made for flaps exhibiting an intact chondrolabral junction with a detached sleeve of chondrolabral tissue from the central acetabulum, and an outside-in designation was made for centrally anchored flaps exhibiting a break in the chondrolabral junction. Radiographic markers of hip impingement/dysplasia were noted for each patient during assignment into 1 of 2 radiographic groups: group 1, lateral center edge angle (LCEA) >20 with FAI, and group 2, LCEA ≤20 with or without cam FAI. Associations between chondral flap morphology and clinical diagnosis were tested using a chi-square test. Results: Overall, 95 patients (103 hips) were included (group 1, 78 hips; group 2, 25 hips). Among hips in group 2, 24 had concurrent cam FAI. There was a significant relationship between chondral flap type and radiographic diagnosis ( P < .001). Among group 1 hips, 78% exhibited outside-in type chondral flaps, 12% exhibited combined outside-in and inside-out flaps, and 10% exhibited inside-out flaps. Group 2 hips showed 72% inside-out type chondral flaps, 16% combined, and 12% outside-in. Hips exhibiting outside-in type flaps were significantly more likely to be in group 1 (positive predictive value [PPV], 91%; negative predictive value [NPV], 69%). Similarly, hips exhibiting inside-out type flaps were significantly more likely to be in group 2 (PPV, 56%; NPV, 95%). Altogether, 90% of group 1 hips exhibited an outside-in lesion and 88% of group 2 hips exhibited an inside-out lesion. Conclusion: Acetabular chondral flap type visualized during hip arthroscopy correlates with radiographic markers of hip impingement and hip instability. Outside-in flaps are highly predictive of FAI, whereas inside-out flaps are highly predictive of acetabular dysplasia.

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