Osteoarthritis of the hip joint in elderly patients is most commonly atrophic, with low parameters of acetabular dysplasia and possible involvement of osteoporosis

Abstract

SummaryAs elderly patients with hip osteoarthritis aged, acetabular dysplasia parameters decreased (Sharp’s angle, acetabular roof obliquity angle, and acetabular head index) and the incidence of the atrophic type increased. Vertebral body fracture was more frequent in the atrophic type, suggesting the involvement of osteoporosis at the onset of hip osteoarthritis.IntroductionOsteoarthritis (OA) is associated with increased bone formation at a local site. However, excessive bone resorption has also been found to occur in the early stages of OA. Osteoporosis may be involved in the onset of OA in elderly patients. We conducted a cross-sectional radiographic study of patients with hip OA and examined the association between age and factors of acetabular dysplasia (Sharp’s angle, acetabular roof obliquity angle, and acetabular head index) as well as the osteoblastic response to determine the potential involvement of osteoporosis.MethodsThis study included 366 patients (58 men, 308 women) who had undergone total hip arthroplasty for the diagnosis of hip OA. We measured the parameters of acetabular dysplasia using preoperative frontal X-ray images and evaluated each patient according to Bombelli classification of OA (hypertrophic, normotrophic, or atrophic type).ResultsAs the patients aged, the parameters of acetabular dysplasia decreased. The incidence of the atrophic type of OA was significantly higher in older patients. Vertebral body fractures were more frequent in the atrophic type than in the other types. Additionally, the index of acetabular dysplasia was lower in the atrophic type. By contrast, the hypertrophic type was present in relatively younger patients and was associated with an increased index of acetabular dysplasia.ConclusionIn elderly patients with hip OA, the parameters of acetabular dysplasia decreased and the incidence of the atrophic type increased as the patients aged. The frequency of vertebral body fracture was high in patients with the atrophic type, suggesting the involvement of osteoporosis in the onset of hip OA.

Incidence, trends, and associated risks of developmental hip dysplasia in patients with Early Onset and Adolescent Idiopathic Scoliosis

“…These results are reflective of the pathogenesis and epidemiology of hip arthroplasty in the adult population, where older patients with significant arthritis make up the majority of the cohort undergoing arthroplasty. 17,18 Potential follow up investigations could look to compare the rates of hip pathology in adult patients who were diagnosed with EOS/AIS and compare the age at which they experienced those pathologies to controls. Other studies could look at bone mineral density in early hip pathology patients with EOS/AIS.…”

Histological evaluation of acetabular bone quality during revision hip arthroplasty

“…24 The presence of osteopenia, noticeable to optical microscopy as a diffuse fractional bone resorption of the bone section and enlargement of the medullary spaces, was significantly more represented in the group of cases, suggesting greater fragility and lower bone resistance to the load. 25 The same bone resorption and bone resorption activity, shown by the presence of osteoclasts, was microscopically more significative in samples belonging to RG. However, there was no statistically significant difference between groups regarding the presence of osteoclasts; a similar result was obtained also with regard to samples from patients with aseptic and septic loosening included in the study group.…”

“…The presence of osteopenia, noticeable to optical microscopy as a diffuse fractional bone resorption of the bone section and enlargement of the medullary spaces, was significantly more represented in the group of cases, suggesting greater fragility and lower bone resistance to the load. 25…”

The Management between Comorbidities and Pain Level with Physical Activity in Individuals with Hip Osteoarthritis with Surgical Indication: A Cross-Sectional Study

“…The hip joint is one of the joints most affected by OA, with a lifetime risk (until 85 years) of 25% [ 8 ]. The appearance of this joint disease in younger age groups increased due to the early diagnosis of morphostuctural malformations [ 9 ].…”