Skip to main content
SpringerLink
Log in

Hip Osteoarthritis: Definition and Etiology

  • Reference work entry
  • First Online:
Hip Arthroscopy and Hip Joint Preservation Surgery

Abstract

Hip osteoarthritis (OA) is a degenerative process where continued cartilage breakdown results from mechanical overload, causing secondary bony and synovial changes and characteristic clinical and radiographic findings. Evidence is accumulating that primary hip OA is actually secondary to a subtle mechanical problem like mild dysplasia or femoroacetabular impingement (FAI). Dysplasia causes increased cartilage stress at the lateral acetabular rim, with labral hypertrophy and cartilage breakdown. FAI causes damage when the hip is flexed. Cam-type FAI causes cartilage delamination and separation of the labral-chondral junction, while pincer-type FAI causes a crushing injury to the labrum and a linear pattern of cartilage damage. Family history is a known risk factor for hip OA, and both FAI and dysplasia can be inherited. In addition, certain genotypes appear to make the cartilage more vulnerable to mechanical overloading. Nonetheless, not all radiographic hip OA is symptomatic, and not everyone with FAI or dysplasia ultimately develops hip OA. Thus, it appears that end-stage hip OA is a multifactorial process, caused by a combination of a structural deformity, wear due to activity, the inherent “robustness” of the cartilage, and the amount of inflammation that the individual experiences. The understanding of the structural factors that contribute to hip OA is advancing rapidly. It also appears that identification and treatment of FAI and dysplasia help symptoms that result from early chondrolabral damage.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 599.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 799.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Steadman’s medical dictionary. 26th ed. Baltimore: Williams &Wilkins; 1995. Arthritis; p. 149, arthrosis; p. 151; osteoarthritis; p. 1267.

    Google Scholar 

  2. Temple-Wong MM, Bae WC, Chen MQ, Bugbee WD, Amiel D, Coutts RD, et al. Biomechanical, structural, and biochemical indices of degenerative and osteoarthritic deterioration of adult human articular cartilage of the femoral condyle. Osteoarthr Cartil. 2009;17:1469–76.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  3. Hill AB. The environment and disease: Association or causation? Proc R Soc Med. 1965;58:295–300.

    CAS  PubMed Central  PubMed  Google Scholar 

  4. Murphy LB, Helmick CG, Schwartz TA, et al. One in four people may develop symptomatic hip osteoarthritis in his or her lifetime. Osteoarthritis Cartilage. 2010;18:1372–9.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  5. Franklin J, Ingvarsson T, Englund M, Ingimarsson O, Robertsson O, Lohmander LS. Natural history of radiographic hip osteoarthritis: a retrospective cohort with 11–28 years of followup. Arthritis Care Res. 2011;63:689–95.

    Article  Google Scholar 

  6. Payne KA, Didiano DM, Chu CR. Donor sex and age influence the chondrogenic potential of human femoral bone marrow stem cells. Osteoarthritis Cartilage. 2010;18:705–13.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  7. Kurtz S, Ong K, Lau E, Mowat F, Halpern M. Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg Am. 2007;89-A:780–5.

    Article  Google Scholar 

  8. Sulsky SI, Carlton L, Bochmann F, et al. Epidemiological evidence for work load as a risk factor for osteoarthritis of the hip: a systematic review. PLoS ONE. 2012;7:e31521.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  9. Vingard E, Alfredsson L, Goldie I, Hogstedt C. Sports and osteoarthritis of the hip. An epidemiologic study. Am J Sports Med. 1993;21:195–200.

    Article  CAS  PubMed  Google Scholar 

  10. Vingard E, Alfredsson L, Malchau H. Osteoarthrosis of the hip in women and its relationship to physical load from sports activities. Am J Sports Med. 1998;26:78–82.

    CAS  PubMed  Google Scholar 

  11. Wang Y, Wluka AE, Simpson JA, et al. Body weight at early and middle adulthood, weight gain and persistent overweight from early adulthood are predictors of the risk of total knee and hip replacement for osteoarthritis. Rheumatology. 2013;52:1033–41.

    Google Scholar 

  12. Ganz R, Leunig M, Leunig-Ganz K, Harris WH. The etiology of osteoarthritis of the hip: an integrated mechanical concept. Clin Orthop Relat Res. 2008;466:264–72.

    Article  PubMed Central  PubMed  Google Scholar 

  13. MacGregor AJ, Antoniades L, Matson M, Andrew T, Spector TD. The genetic contribution to radiographic hip osteoarthritis in women. Results of a classic twin study. Arthritis Rheum. 2000;43:2410–6.

    Article  CAS  PubMed  Google Scholar 

  14. Pollard TCB, Batra RN, Judge A, et al. The hereditary predisposition to hip osteoarthritis and its association with abnormal joint morphology. Osteoarthritis Cartilage. 2013;21:314–421.

    Article  CAS  PubMed  Google Scholar 

  15. Baker-LePain JC, Lynch JA, Parimi N, et al. Variant alleles of the Wnt antagonist FRZB are determinants of hip shape and modify the relationship between hip shape and osteoarthritis. Arthritis Rheum. 2012;64:1457–65.

    Article  PubMed Central  PubMed  Google Scholar 

  16. Castaño Betancourt MC, Cailotto F, Kerkhof HJ, et al. Genome-wide association and functional studies identify the DOT1L gene to be involved in cartilage thickness and hip osteoarthritis. Proc Natl Acad Sci USA. 2012;109:8218–23.

    Article  PubMed Central  PubMed  Google Scholar 

  17. Murphy SB, Ganz R, Müller ME. The prognosis in untreated dysplasia of the hip. A study of radiographic factors that predict outcome. J Bone Joint Surg Am. 1995;77-A:985–9.

    Google Scholar 

  18. Lee CB, Mata-Fink A, Millis MB, Kim YJ. Demographic differences in adolescent-diagnosed and adult-diagnosed acetabular dysplasia compared with infantile developmental dysplasia of the hip. J Pediatr Orthop. 2013;33:107–11.

    Article  PubMed  Google Scholar 

  19. Engsæter IO, Lie SA, Lehmann TG, Furnes O, Vollset SE, Engesæter LB. Neonatal hip instability and risk of total hip replacement in young adulthood. Acta Orthop. 2008;79:321–6.

    Article  Google Scholar 

  20. Loder RT, Skopelja EN. Epidemiology and demographics of hip dysplasia. ISRN Orthop. 2011; Article ID 238607, p. 47.

    Google Scholar 

  21. Jingushi S, Ohfuji S, Sofue M, et al. Multiinstitutional epidemiological study regarding osteoarthritis of the hip in Japan. J Orthop Sci. 2010;15:626–31.

    Article  PubMed  Google Scholar 

  22. Chegini S, Beck M, Ferguson SJ. The effects of impingement and dysplasia on stress distributions in the hip joint during sitting and walking: a finite element analysis. J Orthop Res. 2009;27:195–201.

    Article  PubMed  Google Scholar 

  23. Zhao X, Chosa E, Totoribe K, Deng G. Effect of periacetabular osteotomy for acetabular dysplasia by three-dimensional finite element analysis. J Orthop Sci. 2010;15:632–40.

    Article  PubMed  Google Scholar 

  24. Klaue K, Durnin CW, Ganz R. The acetabular rim syndrome: a clinical presentation of dysplasia of the hip. J Bone Joint Surg Br. 1991;73-B:423–9.

    Google Scholar 

  25. Matej D, Iglic A, Kral-Iglic V. Hip contact stress during normal and staircase walking: the influence of acetabular anteversion angle and lateral coverage of the acetabulum. J Appl Biomech. 2008;24:88–93.

    Google Scholar 

  26. Nogier A, Bonin N, May O, et al. Descriptive epidemiology of mechanical hip pathology in adults under 50 years of age. Prospective series of 292 cases: clinical and radiological aspects and physiopathological review. Orthop Traumatol Surg Res. 2010;96S:S53–8.

    Article  Google Scholar 

  27. Fujii M, Nakashima Y, Yamamoto T, et al. Acetabular retroversion in developmental dysplasia of the hip. J Bone Joint Surg Am. 2010;92:895–903.

    Article  PubMed  Google Scholar 

  28. Steppacher SD, Tannast M, Ganz R, Siebenrock KA. Mean 20-year follow-up of Bernese periacetabular osteotomy. Clin Orthop Relat Res. 2008;466:1633–44.

    Article  PubMed Central  PubMed  Google Scholar 

  29. Ganz R, Parvizi J, Beck M, Leunig M, Nötzli H, Siebenrock KA. Femoroacetabular impingement: a cause for osteoarthritis of the hip. Clin Orthop Relat Res. 2003;417:112–20.

    PubMed  Google Scholar 

  30. Poirier P. Traité d’anatomie humaine, vol. 1. Embryologie (Prenant A.) Ostéologie et Arthologie [Treatise of human anatomy, vol. 1 embryology (Prenant A) osteology and arthrology] (in French) Paris: Masson; 1899. pp. 516–26.

    Google Scholar 

  31. von Mikulicz J. In: von Bergmann E, von Bruns P, von Mikulicz J, editors. Handbuch der praktischen Chirurgie, Bd IV, Chirurgie der Extremitäten. [Handbook of surgical practice, vol. 4, Extremity surgery.] (in German). Stuttgart: Enke; 1903. p. 600.

    Google Scholar 

  32. Smith-Petersen MN. Treatment of malum coxae senilis, old slipped upper femoral epiphysis, intrapelvic protrusion of the acetabulum, and coxa plana by means of acetabuloplasty. J Bone Joint Surg. 1936;18:869–80.

    Google Scholar 

  33. Leunig M, Casillas MM, Hamlet M, et al. Slipped capital femoral epiphysis. Early mechanical damage to the acetabular cartilage by a prominent femoral metaphysis. Acta Orthop Scand. 2000;71:370–5.

    Article  CAS  PubMed  Google Scholar 

  34. Beck M, Kalhor M, Leunig M, Ganz R. Hip morphology influences the pattern of damage to the acetabular cartilage: femoroacetabular impingement as a cause of osteoarthritis of the hip. J Bone Joint Surg Br. 2005;87(B):1012–8.

    Article  CAS  PubMed  Google Scholar 

  35. Kelly BT, Weiland DE, Schenker ML, Philippon MJ. Arthroscopic labral repair in the hip: surgical technique and review of the literature. Arthroscopy. 2005;21:1496–504.

    Article  PubMed  Google Scholar 

  36. Kienle KP, Keck J, Werlen S, Kim YJ, Siebenrock KA, Mamisch TC. Femoral morphology and epiphyseal growth plate changes of the hip during maturation: MR assessments in a 1-year follow-up on a cross-sectional asymptomatic cohort in the age range of 9–17 years. Skeletal Radiol. 2012;41:1381–90.

    Article  PubMed  Google Scholar 

  37. Eijer H, Podeszwa DA, Ganz R, Leunig M. Evaluation and treatment of young adults with femoroacetabular impingement secondary to Perthes’ disease. Hip Int. 2006;16:273–80.

    CAS  PubMed  Google Scholar 

  38. Wagner S, Hofstetter W, Chiquet M, et al. Early osteoarthritic changes of human femoral head cartilage subsequent to femoro-acetabular impingement. Osteoarthritis Cartilage. 2003;11:508–18.

    Article  CAS  PubMed  Google Scholar 

  39. Hetsroni I, Larson CM, Dela Torre K, Zbeda RM, Magennis E, Kelly BT. Anterior inferior iliac spine deformity as an extra-articular source for hip impingement: a series of 10 patients treated with arthroscopic decompression. Arthroscopy. 2012;11:1644–53.

    Article  Google Scholar 

  40. Leunig M, Nho SJ, Turchetto L, Ganz R. Protrusio acetabuli: new insights and experience with joint preservation. Clin Orthop Relat Res. 2009;467:2241–50.

    Article  PubMed Central  PubMed  Google Scholar 

  41. Corten K, Ganz R, Chosa E, Leunig M. Bone apposition of the acetabular rim in deep hips: a distinct finding of global pincer impingement. J Bone Joint Surg Am. 2011;93 Suppl 2:10–6.

    PubMed  Google Scholar 

  42. Reichenbach S, Jüni P, Werlen S, et al. Prevalence of cam-type deformity on hip magnetic resonance imaging in young males. A cross-sectional study. Arthritis Care Res. 2010;62:1319–27.

    Article  Google Scholar 

  43. Leunig M, Jüni P, Werlen S, et al. Prevalence of cam and pincer-type deformities on hip MRI in an asymptomatic young Swiss female population: a cross-sectional study. Osteoarthritis Cartilage. 2013;21:544–50.

    Article  CAS  PubMed  Google Scholar 

  44. Bardakos NV, Villar RN. Predictors of progression of osteoarthritis in femoroacetabular impingement: a radiological study with a minimum of ten years follow-up. J Bone Joint Surg Br. 2009;91:162–9.

    Article  CAS  PubMed  Google Scholar 

  45. Clohisy JC, Dobson MA, Robison JF, et al. Radiographic structural abnormalities associated with premature, natural hip-joint failure. J Bone Joint Surg Am. 2011;93 Suppl 2:3–9.

    Article  PubMed  Google Scholar 

  46. Andersson S, Nilsson B, Hessell T, et al. Degenerative joint disease in ballet dancers. Clin Orthop Relat Res. 1989;236:233–6.

    Google Scholar 

  47. van Dijk CN, Lim LSL, Poortman A, Strübbe EH, Marti RK. Degenerative joint disease in female ballet dancers. Am J Sports Med. 1995;23:295–300.

    Article  PubMed  Google Scholar 

  48. Murray RO, Duncan C. Athletic activity in adolescence as an etiological factor in degenerative hip disease. J Bone Joint Surg Br. 1971;53-B:406–19.

    Google Scholar 

  49. Kapron AL, Anderson AE, Aoki SK, et al. Radiographic prevalence of femoroacetabular impingement in collegiate football players. AAOS Exhibit Selection. J Bone Joint Surg Am. 2011;93:e111.

    Article  PubMed  Google Scholar 

  50. Gerhardt MB, Romero AA, Silvers HJ, Harris DJ, Watanabe D, Mandelbaum B. The prevalence of radiographic hip abnormalities in elite soccer players. Am J Sports Med. 2012;40:584–8.

    Article  PubMed  Google Scholar 

  51. Silvis ML, Mosher TJ, Smetana BS, et al. High prevalence of pelvic and hip magnetic resonance imaging findings in asymptomatic collegiate and professional hockey players. Am J Sports Med. 2011;39:715–21.

    Article  PubMed  Google Scholar 

  52. Siebenrock KA, Ferner F, Noble PC, Santore RF, Werlen S, Mamisch TC. The cam-type deformity of the proximal femur arises in childhood in response to vigorous sporting activity. Clin Orthop Relat Res. 2011;469:3229–40.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Kaiser Permanente Medical Center, 1200 El Camino Real, South San Francisco, CA, 94080, USA

    Lisa M. Tibor

  2. Emeritus Inselspital Bern, Bern, Switzerland

    Reinhold Ganz

  3. Faculty of Medicine, University of Bern, 3010, Bern, Switzerland

    Reinhold Ganz

Authors
  1. Lisa M. Tibor
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Reinhold Ganz
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Lisa M. Tibor .

Editor information

Editors and Affiliations

  1. Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, USA

    Shane J. Nho

  2. Department of Orthopaedic Surgery, Schulthess Klinik, Zurich, Switzerland

    Michael Leunig

  3. Minnesota Orthopedic Sports Medicine Institute, Twin Cities Orthopedics - Edina, Edina, Minnesota, USA

    Christopher M. Larson

  4. Department of Orthopaedics, University of Michigan, Ann Arbor, Michigan, USA

    Asheesh Bedi

  5. Sports Medicine and Shoulder Service and Center for Hip Preservation Surgery, Hospital for Special Surgery, New York, New York, USA

    Bryan T. Kelly

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer Science+Business Media New York

About this entry

Cite this entry

Tibor, L.M., Ganz, R. (2015). Hip Osteoarthritis: Definition and Etiology. In: Nho, S., Leunig, M., Larson, C., Bedi, A., Kelly, B. (eds) Hip Arthroscopy and Hip Joint Preservation Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-6965-0_9

Download citation

  • DOI: https://doi.org/10.1007/978-1-4614-6965-0_9

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-6964-3

  • Online ISBN: 978-1-4614-6965-0

  • eBook Packages: MedicineReference Module Medicine

Publish with us

Policies and ethics

Search

Navigation