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

Abstract

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). Signifi cant 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.

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

“…Studies using various imaging methods in young adults have identified slightly higher alpha angles in right vs. left hips 20, 46, 47 . In two radiographic studies of acetabular dysplasia, CEA was smaller on the right compared with the left 48, 49 . Differences by side should be explored in other populations and larger samples, and if confirmed, underlying biomechanical explanations (e.g.…”

Genome-wide association study of developmental dysplasia of the hip identifies an association with GDF5

“…Finally, our replication cohorts mainly comprised independent populations of children recruited prospectively with a firm diagnosis of DDH, and in whom the EAF and odds ratio of association for the primary variant signal was almost identical as that found in the NJR discovery sample. DDH is a risk factor for degenerative disease at the hip 11,12,23 , and osteoarthritis susceptibility genes influence the association between hip morphology and osteoarthritis 15,24,25 . We therefore also examined whether we were simply detecting osteoarthritis-associated genetic loci in our DDH discovery cohort, as case identification required NJR registration for a hip replacement.…”

The role of femoral neck anteversion in the development of osteoarthritis in dysplastic hips

“…Geometrical measurements of the morphology of the hip taken from radiographs, such as acetabular depth and CE angle, have been investigated previously in OA, with varying results. 22 Cross-sectional studies in western European and Japanese populations have supported an association between dysplasia and OA of the hip. [23][24][25] However, Asian, African and Turkish populations appear to have a different prevalence of OA of the hip in relation to acetabular dysplasia, compared with that of western Europeans, [26][27][28] although none of these studies considered the effect of femoral morphology.…”