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

Abstract

Objectives We sought to describe the effect of alterations in hip morphology with respect to worsening hip OA in a community-based sample including African American (AA) and white men and women. Methods This nested case-control study defined case hips as Kellgren Lawrence grade (KLG)<3 on baseline supine pelvis radiographs and KLG≥3 or THR for OA at the 1st or 2nd follow-up visit (mean 6 and 13 years, respectively); control hips had KLG<3 at both visits, with gender/race distribution similar to cases. Hip morphology was assessed using HipMorf software (Oxford, UK). Descriptive means and standard errors were obtained from generalized estimating equation (GEE) models. Sex-stratified GEE regression models (accounting for within-person correlation), adjusted for age, race, BMI, and side were then employed. Results A total of 120 individuals (239 hips; 71 case/168 control) were included (25% male, 26% AA, mean age 62 years, BMI 30 kg/m2). Case hips tended to have greater baseline AP alpha angles, smaller minimum joint space width (mJSW) and more frequent triangular index signs. Adjusted results among men revealed that higher AP alpha angle, Gosvig ratio, and acetabular index were positively associated with case hips; coxa profunda was negatively associated. Among women, greater AP alpha angle, smaller mJSW, protrusio acetabuli, and triangular index sign were associated with case hips. Conclusions We confirmed an increased risk of worsening hip OA due to baseline features of cam deformity among men and women, as well as protrusio acetabuli among women, and provide the first estimates of these measures in AAs.

Differences between race and sex in measures of hip morphology: a population-based comparative study

“…Differences in hip joint shape and morphology have been identified between racial groups and the sexes. Chinese hips show reduced coverage with a more spherical head shape of the femur than Caucasians 7,18 , while African Americans show differences in proximal femur and acetabular measures to Caucasians 19 . Among African Americans 20 , Chinese 8 and Japanese 21 , males show greater prevalence of radiographic hip OA (RHOA) than females, with Caucasian groups showing mixed results 20,22 .…”

“…Morphometric data was obtained from included x-rays using OxMorf 2.0.0, a validated software program developed by the University of Oxford that assesses 23 hip morphology parameters. This software has shown high reproducibility for using hip morphology measures to predict incident total hip replacement in a population-based cohort 11,19,32 .…”

“…These include measures of acetabular orientation (depth, width, depth to width ratio) 33 , acetabular coverage (LCE) 11,23,32,33 , minimum joint space width as calculated using Bezier curves 30,34,35 , femoral head asphericity (AP alpha angle) 11,33 , femoral morphology (neck length, minimum neck width, head diameter) 36 , femoral alignment (femoral neck shaft angle [FNSA]) 37 . Pelvic width (inter-acetabular edge distance) along with the FNSA and acetabular depth to width ratio were measured due to likely sex-differences 19,24 . Hip morphology measures are described in Figs.…”

Cam deformity and the omega angle, a novel quantitative measurement of femoral head-neck morphology: a 3D CT gender analysis in asymptomatic subjects

“…The α°, the most frequently used parameter to grade cam morphology and describe the FHN junction, has been suggested as a predictor for the risk of anterior impingement and extent of cartilage defects [17,18]. However, an α°mea-surement is performed in only one plane and so is highly dependent on the position at which it is measured [19].…”

The Role of Gdf5 Regulatory Regions on Development of Hip Morphology and Susceptibility to Osteoarthritis and Dislocation

“…(12-14, 16-18) These types of regulatory mutations often have less pleiotropic effects on phenotypes. For example, recent reports have shown substantial variations in these hip morphologic features between subjects with progressive hip OA and matched controls,(2, 23, 24) and candidate association and GWAS studies have repeatedly revealed the association of the GDF5 locus with OA, including that of the hip. In these studies, a large 130 kb haplotype underlies risk of OA at the locus.…”