The Importance of Hip Shape in Predicting Hip Osteoarthritis
- 7 Downloads
Purpose of review
This narrative review summarizes the evidence relating hip shape and risk of osteoarthritis at the hip, with a focus on the most recent body of work.
Hip osteoarthritis (OA) is a prevalent and potentially disabling condition with few effective non-surgical treatment options. Risk factors for hip OA appear to differ somewhat from those at other sites. Variations in hip morphology, whether assessed through standard geometric measures or statistical modeling methods, seem to increase hip OA risk and may provide a novel approach to interventions to reduce or prevent OA. Such variations have also led to focused surgical interventions to “correct” abnormal shape, although comparisons with non-surgical management are lacking.
There remains a lack of understanding regarding the optimal management, whether surgical, non-surgical, or a combination, for FAI syndrome. Even less is known regarding other potential morphologic variations that may contribute to OA risk. Additionally, many individuals who have shape variations that would seem to increase their risk will never develop hip OA. Questions remain regarding key risk factors for hip OA development, which individuals should be targeted for therapies, whether directed at symptoms, function, or prevention, and which therapies should be studied and offered. Trials are underway to help address some of these questions.
KeywordsHip osteoarthritis Hip morphology Cam and pincer morphology Femoroacetabular impingement
Compliance with Ethical Standards
Conflict of Interest
Amanda E. Nelson reports grants from NIAMS K23AR061406 and the CDC, during the conduct of the study, and personal fees from GSK and from Health Press Ltd., outside the submitted work.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
References and Recommended Reading
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
- 2.Jafarzadeh SR, Felson DT. Updated estimates suggest a much higher prevalence of arthritis in US adults than previous ones. Arthritis Rheumatol. 2018;70(2):185–92.Google Scholar
- 3.Katz JN. Prevalence of arthritis revisited. Arthritis Rheumatol. 2018;70(2):153–4.Google Scholar
- 5.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(4):780–5.Google Scholar
- 8.Jordan JM, Helmick CG, Renner JB, Luta G, Dragomir AD, Woodard J, et al. Prevalence of hip symptoms and radiographic and symptomatic hip osteoarthritis in African Americans and Caucasians: the Johnston County Osteoarthritis Project. J Rheumatol. 2009;36(4):809–15.CrossRefPubMedPubMedCentralGoogle Scholar
- 10.Nelson AE, Allen KD, Golightly YM, Goode AP, Jordan JM. A systematic review of recommendations and guidelines for the management of osteoarthritis: the chronic osteoarthritis management initiative of the U.S. bone and joint initiative. Semin Arthritis Rheum. 2014;43(6):701–12.CrossRefPubMedGoogle Scholar
- 11.• Meneses SR, Goode AP, Nelson AE, Lin J, Jordan JM, Allen KD, et al. Clinical algorithms to aid osteoarthritis guideline dissemination. Osteoarthr Cartil. 2016;24(9):1487–99. This overview of current OA management guidelines from a number of different expert organizations also provides more practical treatment algorithms for clinical use.CrossRefPubMedGoogle Scholar
- 13.•• Nepple JJ, Clohisy JC. Evolution of Femoroacetabular Impingement Treatment: The ANCHOR Experience. Am J Orthop (Belle Mead NJ). 2017;46(1):28–34. This group, including the leaders in the area, summarizes the current state and data regarding FAI surgical interventions.Google Scholar
- 20.de Sa D, Horner NS, MacDonald A, Simunovic N, Slobogean G, Philippon MJ, et al. Evaluating healthcare resource utilization and outcomes for surgical hip dislocation and hip arthroscopy for femoroacetabular impingement. Knee Surg Sports Traumatol Arthrosc. 2016;24(12):3943–54.CrossRefPubMedGoogle Scholar
- 23.•• Fairley J, Wang Y, Teichtahl AJ, Seneviwickrama M, Wluka AE, Brady SRE, et al. Management options for femoroacetabular impingement: a systematic review of symptom and structural outcomes. Osteoarthritis Cartilage. 2016;24(10):1682–96. This systematic review summarizes all the available data regarding FAI management through 2016. CrossRefPubMedGoogle Scholar
- 24.•• Griffin DR, Dickenson EJ, O'Donnell J, Agricola R, Awan T, Beck M, et al. The Warwick Agreement on femoroacetabular impingement syndrome (FAI syndrome): an international consensus statement. Br J Sports Med. 2016;50(19):1169–76. This paper describes a consensus meeting and agreement regarding definitions of FAI syndrome, imaging findings, and current treatment options.CrossRefPubMedGoogle Scholar
- 25.• Raveendran R, Stiller JL, Alvarez C, Renner JB, Schwartz TA, Arden NK, et al. Population-based prevalence of multiple radiographically-defined hip morphologies: the Johnston County Osteoarthritis Project. Osteoarthritis Cartilage. 2018;26(1):54–61. This recent paper from our group describes the frequency of radiographic cam and pincer morphologies in a population-based US cohort.CrossRefPubMedGoogle Scholar
- 27.Nelson AE, Stiller JL, Shi XA, Leyland KM, Renner JB, Schwartz TA, et al. Measures of hip morphology are related to development of worsening radiographic hip osteoarthritis over 6 to 13 year follow-up: the Johnston County Osteoarthritis Project. Osteoarthr Cartil. 2016;24(3):443–50.CrossRefPubMedGoogle Scholar
- 30.Agricola R, Heijboer MP, Roze RH, Reijman M, Bierma-Zeinstra SM, Verhaar JA, et al. Pincer deformity does not lead to osteoarthritis of the hip whereas acetabular dysplasia does: acetabular coverage and development of osteoarthritis in a nationwide prospective cohort study (CHECK). Osteoarthr Cartil. 2013;21(10):1514–21.CrossRefPubMedGoogle Scholar
- 31.Gregory JS, Waarsing JH, Day J, Pols HA, Reijman M, Weinans H, et al. Early identification of radiographic osteoarthritis of the hip using an active shape model to quantify changes in bone morphometric features: can hip shape tell us anything about the progression of osteoarthritis? Arthritis Rheum. 2007;56(11):3634–43.CrossRefPubMedGoogle Scholar
- 32.Nelson AE, Liu F, Lynch JA, Renner JB, Schwartz TA, Lane NE, et al. Association of incident symptomatic hip osteoarthritis with differences in hip shape by active shape modeling: the Johnston County osteoarthritis project. Arthritis Care Res (Hoboken). 2014;66(1):74–81.CrossRefPubMedCentralGoogle Scholar
- 35.Agricola R, Leyland KM, Bierma-Zeinstra SM, Thomas GE, Emans PJ, Spector TD, et al. Validation of statistical shape modelling to predict hip osteoarthritis in females: data from two prospective cohort studies (cohort hip and cohort knee and Chingford). Rheumatology (Oxford). 2015;54(11):2033–41.CrossRefGoogle Scholar
- 42.Lindner C, Thiagarajah S, Wilkinson JM, arc OC, Wallis GA, Cootes TF. Development of a fully automatic shape model matching (FASMM) system to derive statistical shape models from radiographs: application to the accurate capture and global representation of proximal femur shape. Osteoarthr Cartil. 2013;21(10):1537–44.CrossRefPubMedGoogle Scholar
- 49.Nelson AE, Braga L, Renner JB, Atashili J, Woodard J, Hochberg MC, et al. Characterization of individual radiographic features of hip osteoarthritis in African American and White women and men: the Johnston County Osteoarthritis Project. Arthritis Care Res (Hoboken). 2010;62(2):190–7.Google Scholar
- 55.Agricola R, Heijboer MP, Ginai AZ, Roels P, Zadpoor AA, Verhaar JA, et al. A cam deformity is gradually acquired during skeletal maturation in adolescent and young male soccer players: a prospective study with minimum 2-year follow-up. Am J Sports Med. 2014;42(4):798–806.CrossRefPubMedGoogle Scholar