Eziologia e meccanismi patologici dell’osteoartrosi dell’anca

Abstract

The etiology of osteoarthritis of the hip has long been considered “primary” when no underlying deformity could be diagnosed, or secondary to eg. developmental deformities. Recent information supports the hypothesis that primary osteoarthritis is also secondary to subtle, hitherto unrecognised abnormalities and the initiating pathophysiological mechanism for all is femoroacetabular impingement. Two types have been identified. Cam-type impingement is more often seen in young athletic males and is caused by an offset pathomorphology of the head-neck junction leading to outside-in delamination of the acetabular cartilage. Pincer-type is more prevalent in middle-aged women and is produced by a linear impact between acetabular rim and femoral neck. Surgical attempts to restore normal anatomy should be performed before major cartilage damage is present.