Anteroposterior Thickening of the Femoral Neck With Aging Decreases the “Offset” in Men

Johnson, Jacob K.; Renner, Jordan B.; Dahners, Laurence E.

doi:10.1177/0363546512457158

Cited by 11 publications

(10 citation statements)

References 18 publications

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“…However, there were differences in the surgical findings between the sexes; males had higher incidence of cam lesions as well as a higher incidence of highgrade cartilage damage requiring microfracture and larger labral tears. As previously mentioned, Johnson et al 10 reported that males develop thicker femoral necks with advanced age, and this may explain why males had a higher incidence of cam lesions. The higher incidence of cam lesions might be the reason for the larger labral tears and higher incidence of chondral damage.…”

Section: Discussionmentioning

confidence: 83%

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Sex-Based Differences in the Clinical Presentation of Patients With Symptomatic Hip Labral Tears

et al. 2014

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Section: Discussionmentioning

confidence: 83%

“…The investigators reported that females have smaller alpha angles and increased anteversion. In addition, Johnson et al 10 reported that males develop thicker femoral necks with advanced age, which might lead to increased incidence of femoroacetabular impingement (FAI) in male patients over the years.…”

mentioning

confidence: 99%

Sex-Based Differences in the Clinical Presentation of Patients With Symptomatic Hip Labral Tears

et al. 2014

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“…Some studies have postulated that the increased prevalence in athletes is the result of vigorous sports activity in adolescence, predisposing the growing hip to the development of altered morphology [41,42]. Another possibility is that remodeling of the mature hip as a result of activity-related stresses is neither pathological nor unexpected [20]. We do not have additional insight into the etiology of cam FAI based on our methods (a single radiograph in time).…”

Section: Discussionmentioning

confidence: 91%

The 2015 Frank Stinchfield Award: Radiographic Abnormalities Common in Senior Athletes With Well-functioning Hips but Not Associated With Osteoarthritis

Anderson

Kapron

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Background It is not known whether morphological abnormalities of the hip are compatible with lifelong hip function and avoidance of osteoarthritis (OA). Our purpose was to investigate the prevalence of radiographic findings consistent with femoroacetabular impingement (FAI) and dysplasia (DDH) in senior athletes with well-functioning hips. Questions/purposes (1) What is the prevalence of FAI and DDH in senior athletes with well-functioning hips? (2) Are radiographic findings of FAI and DDH associated with OA? (3) Is a history of longer duration or more intense activity associated with hip pathomorphology? (4) Were the modified Harris hip scores and the Hip Outcome Scores lower (legacy scales) in patients with evidence of hip pathomorphology than those without? Methods Five hundred forty-seven individuals (55% men, 45% women; 1081 hips, 534 bilateral and 13 unilateral), mean age 67 years (SD 8 years), gave consent and qualified for this institutional review board-approved crosssectional study of senior athletes. Hips were independently evaluated for radiographic signs of FAI, DDH, and OA. Additionally, a lifetime activities questionnaire and outcome instruments were used to assess pain and function. Hips that had previously undergone arthroplasty or fracture surgery were excluded. Results Eighty-three percent (898 of 1081) of hips had radiographic abnormalities consistent with FAI, of which 67% (599 of 898) were cam-type FAI. Ten percent (103 of 1081) of hips had radiographic evidence for dysplasia. Radiographic findings of FAI were not predictive of OA after controlling for age and sex (odds ratio [OR], 1.79; 95% confidence interval [CI], 0.48-6.62; p = 0.390). Similarly, radiographic findings of DDH were not predictive of OA (OR, 1.48; 95% CI, 0.31-7.21; p = 0.62). Our data suggest an increased risk of FAItype morphologies in athletes who participated in competitive sporting events during early adult years (OR, 1.49; 95% CI, 1.04-2.11; p = 0.020). Additionally, participants who reported lifetime participation in competitive sports were at an increased risk of OA compared with those who did not (OR, 1.75; 95% CI, 1.14-2.69; p = 0.007). There were no differences in outcome scores between athletes with and without morphologic abnormalities. Conclusions Radiographic findings consistent with FAI in these senior athletes were common and were not associated with the presence of OA. These data suggest that the need to screen for asymptomatic young athletes for radiographic evidence of FAI and DDH may not be necessary. Level of Evidence Level III, prognostic study.

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“…39 Controversy continues as FAI may therefore in some instances be considered the result of ongoing osteoarthritic hip changes. Furthermore Johnson et al, 40 has shown that in males, femoral neck thickening occurs naturally as a result of aging that leads to a progressive 18% decrease in head/neck ratio from ages 20 to 80 years. This is an important source of bias that should be considered especially in studies with predominantly older male populations reporting high rates of CAM-type impingement.…”

Section: Discussionmentioning

confidence: 99%

Does Femoroacetabular Impingement Contribute to the Development of Hip Osteoarthritis? A Systematic Review

Kowalczuk¹,

Yeung²,

Simunovic

et al. 2015

Sports Medicine and Arthroscopy Review

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Femoroacetabular impingement (FAI) has been linked to specific patterns of cartilage damage. The goal of this systematic review is to answer the following questions: (1) Does FAI contribute to the development and progression of hip osteoarthritis (OA)? (2) If FAI does contribute to the development and progression of hip OA, does CAM-type or pincer-type impingement play a greater role? A search of the electronic databases, MEDLINE and EMBASE, was performed to identify relevant studies performed between January 1, 2000 and January 1, 2015 that link the pathophysiology of OA to FAI. Methodological quality of included studies was assessed by 2 reviewers using the Methodological Index for Non-Randomized Studies criteria. An intraclass correlation coefficient with 95% confidence intervals was used to determine agreement between reviewers on quality scores. Overall 35 studies were identified that met inclusion criteria. Certain morphologic features of CAM-type FAI, particularly elevated alpha angle, do seem to predispose select patients to radiographic progression of hip OA. In comparison with pincer-type impingement, the association between CAM-type impingement and hip OA is better understood. Long-term surgical outcome studies will further delineate the role of FAI in the development and progression of hip OA.

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Anteroposterior Thickening of the Femoral Neck With Aging Decreases the “Offset” in Men

Cited by 11 publications

References 18 publications

Sex-Based Differences in the Clinical Presentation of Patients With Symptomatic Hip Labral Tears

Sex-Based Differences in the Clinical Presentation of Patients With Symptomatic Hip Labral Tears

The 2015 Frank Stinchfield Award: Radiographic Abnormalities Common in Senior Athletes With Well-functioning Hips but Not Associated With Osteoarthritis

Does Femoroacetabular Impingement Contribute to the Development of Hip Osteoarthritis? A Systematic Review

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