Mild acetabular dysplasia and risk of osteoarthritis of the hip: a case–control study

Objective To determine whether mild variation in acetabular depth (AD) and shape is a risk factor for osteoarthritis (OA) of the hip. Methods The unaffected contralateral hip of patients with unilateral hip OA was compared with hips of asymptomatic controls without hip OA, derived from the Nottingham Genetics Osteoarthritis and Lifestyle case–control study. Standardised anteroposterior x-rays of the pelvis were used to measure centre edge (CE) angle and AD. Cut-off points for narrow CE angle and shallow AD were calculated from the control group (mean −1.96×SD). The relative risk of hip OA associated with each feature was estimated using OR and 95% CI and adjusted risks were calculated by logistic regression. Results In controls, both the CE angle and the AD were lower in the left hip than in the right hip. The CE angle related to age in both hips, and AD of the right hip was lower in men than in women. The contralateral unaffected hip in patients with unilateral hip OA had a decreased CE angle and AD compared with controls, irrespective of side. The lowest tertile of the CE angle in contralateral hips was associated with an eightfold risk of OA (aOR 8.06, 95% CI 4.87 to 13.35) and the lowest tertile of AD was associated with a 2.5-fold risk of OA (aOR 2.53, 95% CI 1.28 to 5.00). Significant increases in the risk of OA were also found as the CE angle and AD decreased. Conclusion Constitutional mild acetabular dysplasia appears to increase the risk of hip OA.

[1]  David Zurakowski,et al.  Radiographic and patient factors associated with pre-radiographic osteoarthritis in hip dysplasia. , 2009, The Journal of bone and joint surgery. American volume.

[2]  K. Muir,et al.  Attempt to replicate published genetic associations in a large, well-defined osteoarthritis case-control population (the GOAL study). , 2007, Osteoarthritis and cartilage.

[3]  O. Reikerås,et al.  Acetabular dysplasia as an aetiological factor in development of hip osteoarthritis , 2009, International Orthopaedics.

[4]  Michael Doherty,et al.  Nonspherical femoral head shape (pistol grip deformity), neck shaft angle, and risk of hip osteoarthritis: a case-control study. , 2008, Arthritis and rheumatism.

[5]  H. Shindo,et al.  Bilateral incidence and severity of acetabular dysplasia of the hip , 2008, Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association.

[6]  R. Maciewicz,et al.  Radiographic assessment of the index to ring finger ratio (2D:4D) in adults , 2007, Journal of anatomy.

[7]  William H. Harris,et al.  The Etiology of Osteoarthritis of the Hip , 1986, Clinical orthopaedics and related research.

[8]  K. Muir,et al.  Index to ring finger length ratio and the risk of osteoarthritis. , 2008, Arthritis and rheumatism.

[9]  W. Zhang,et al.  Relationship between Heberden’s nodes and underlying radiographic changes of osteoarthritis , 2005, Annals of the rheumatic diseases.

[10]  B. Koes,et al.  Acetabular dysplasia predicts incident osteoarthritis of the hip: the Rotterdam study. , 2005, Arthritis and rheumatism.

[11]  S. Jacobsen,et al.  Hip dysplasia: a significant risk factor for the development of hip osteoarthritis. A cross-sectional survey. , 2005, Rheumatology.

[12]  K. Søballe,et al.  Hip dysplasia and osteoarthrosis , 2005, Acta orthopaedica.

[13]  B. Goker,et al.  Radiographic hip osteoarthritis and acetabular dysplasia in Turkish men and women , 2005, Rheumatology International.

[14]  B. Koes,et al.  Influence of hip dysplasia on the development of osteoarthritis of the hip , 2004, Annals of the rheumatic diseases.

[15]  C. Lavy,et al.  Racial and gender variations in adult hip morphology , 2003, International Orthopaedics.

[16]  A. Silman,et al.  Syndrome of symptomatic adult acetabular dysplasia (SAAD syndrome) , 2003, Annals of the rheumatic diseases.

[17]  K. Muir,et al.  Age and sex differences in hip joint space among asymptomatic subjects without structural change: implications for epidemiologic studies. , 2003, Arthritis & Rheumatism.

[18]  B. Koes,et al.  Prognostic factors of progress of hip osteoarthritis: a systematic review. , 2002, Arthritis and rheumatism.

[19]  T. Spector,et al.  The genetic contribution to radiographic hip osteoarthritis in women: results of a classic twin study. , 2000, Arthritis and rheumatism.

[20]  Koji Inoue,et al.  Prevalence of hip osteoarthritis and acetabular dysplasia in french and japanese adults. , 2000, Rheumatology.

[21]  M. Nevitt,et al.  Association of mild acetabular dysplasia with an increased risk of incident hip osteoarthritis in elderly white women: the study of osteoporotic fractures. , 2000, Arthritis and rheumatism.

[22]  K. Muir,et al.  Screening for hand osteoarthritis (OA) using a postal survey. , 1999, Osteoarthritis and cartilage.

[23]  E. Vignon,et al.  Quantitative measurement of joint space narrowing progression in hip osteoarthritis: a longitudinal retrospective study of patients treated by total hip arthroplasty. , 1998, British journal of rheumatology.

[24]  D Coggon,et al.  Individual risk factors for hip osteoarthritis: obesity, hip injury, and physical activity. , 1998, American journal of epidemiology.

[25]  C. Cooper,et al.  Acetabular dysplasia and osteoarthritis of the hip in elderly white women , 1997, Annals of the rheumatic diseases.

[26]  A. Silman,et al.  Osteoarthritis of the hip and acetabular dysplasia in Nigerian men. , 1996, The Journal of rheumatology.

[27]  C. Cooper,et al.  Osteoarthritis of the hip joint and acetabular dysplasia in women. , 1995, Annals of the rheumatic diseases.

[28]  D Coggon,et al.  Osteoarthritis of the hip and acetabular dysplasia. , 1991, Annals of the rheumatic diseases.

[29]  R. O. Murray,et al.  The aetiology of primary osteoarthritis of the hip. , 1965, The British journal of radiology.