Sex Differences of Hip Morphology in Young Adults With Hip Pain and Labral Tears

Hetsroni, Iftach; Torre, Katrina Dela; Duke, Gavin; Lyman, Stephen; Kelly, Bryan T.

doi:10.1016/j.arthro.2012.07.008

Cited by 110 publications

(118 citation statements)

References 36 publications

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“…Furthermore, females had increased acetabular anteversion at maturity compared with males. Results from other work have shown increased acetabular anteversion in adult females compared with adult males [6,14].…”

Section: Discussionmentioning

confidence: 80%

“…It is plausible that as pelvic incidence increases, stresses from the femoral head are directed toward more posterior regions of the acetabulum, stimulating appositional growth of both bone and cartilage at the periphery of the acetabulum. The increased acetabular anteversion seen in adult females compared with males [6,14] may correlate with the increased pelvic incidence some studies have shown in adult females [16,20]. The amount of actual articular cartilage providing coverage of the femoral head is important for long-term prognosis of a hip.…”

Section: Discussionmentioning

confidence: 99%

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Sex Differences in Cartilage Topography and Orientation of the Developing Acetabulum: Implications for Hip Preservation Surgery

Peterson

Doan

Bomar

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background Increased attention is being placed on hip preservation surgery in the early adolescent. An understanding of three-dimensional (3-D) acetabular development as children approach maturity is essential. Changes in acetabular orientation and cartilage topography have not previously been quantified as the adolescent acetabulum completes development. Questions/purposes We used a novel 3-D CT analysis of acetabular development in children and adolescents to determine (1) if there were sex-specific differences in the growth rate or surface area of the acetabular articular cartilage; (2) if there were sex-specific differences in acetabular version or tilt; and (3) whether the amount of version and tilt present correlated with acetabular coverage. Methods We assessed acetabular morphology in 157 patients (314 hips); 71 patients were male and 86 were female. Patient ages ranged from 8 years to 17 years. A 3-D surface reconstruction of each pelvis was created from CT data using MIMICs software. Custom MATLAB software was used to obtain data from the 3-D reconstructions. We calculated articular surface area, acetabular version, and acetabular tilt as well as novel measurements of acetabular morphology, which we termed ''coverage angles.'' These were measured in a radial fashion in all regions of the acetabulum. Data were organized into three age groups: 8 to 10 years old, 10 to 13 years old, and 13 to 17 years old. Results Male patients had less acetabular anteversion in all three age groups, including at maturity (7°versus 13°, p \ 0.001; 10°versus 17°, p \ 0.001; 14°versus 20°, p \ 0.001). Males had less acetabular tilt in all three age groups (32°versus 34°, p = 0.03; 34°versus 38°, p \ 0.001; 39°versus 41°, p = 0.023). Increases in anteversion correlated with increased posterior coverage angles (r = 0.805; p \ 0.001). Increases in tilt were correlated with increases in superior coverage angles (r = 0.797; p \ 0.001). The posterosuperior regions of the acetabulum were the last to develop and this process occurred earlier in females compared with males.

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Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Sex Differences in Cartilage Topography and Orientation of the Developing Acetabulum: Implications for Hip Preservation Surgery

Peterson

Doan

Bomar

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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“…Sex may also influence both the kind and magnitude of pathoanatomy. For example, symptomatic dysplasia and excessive femoral anteversion are more common in females [18,20,35,49,54]. In several series of patients with FAI, women with symptomatic impingement had smaller cam deformities [17,20,24,37] but could present with worse preoperative scores for pain and function than men [23].…”

Section: Introductionmentioning

confidence: 99%

Two or More Impingement and/or Instability Deformities Are Often Present in Patients With Hip Pain

Tibor¹,

Liebert

Sutter

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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Background Damage to the hip can occur due to impingement or instability caused by anatomic factors such as femoral and acetabular version, neck-shaft angle, alpha angle, and lateral center-edge angle (CEA). The associations between these anatomic factors and how often they occur in a painful hip are unclear but if unaddressed might explain failed hip preservation surgery. Questions/purposes We determined (1) the influence of sex on the expression of impingement-related or instability-related factors, (2) the associations among these factors, and (3) how often both impingement and/or instability factors occur in the same hip.Methods We retrospectively reviewed a cohort of 170 hips (145 patients) undergoing MR arthrography of the hip for any reason. We excluded 58 hips with high-grade dysplasia, Perthes' sequelae, previous surgery, or incomplete radiographic information, leaving 112 hips (96 patients). We measured femoral version and alpha angles on MR arthrograms. Acetabular anteversion, lateral CEA, and neck-shaft angle were measured on pelvic radiographs. Results We observed a correlation between sex and alpha angle. Weak or no correlations were observed between the other five parameters. In 66% of hips, two or more (of five) impingement parameters, and in 51% of hips, two or more (of five) instability parameters were found. Conclusions Patients with hip pain frequently have several anatomic factors potentially contributing to chondrolabral damage. To address pathologic hip loading due to impingement and/or instability, all of the anatomic influences should be known. As we found no associations between anatomic factors, we recommend an individualized assessment of each painful hip. Level of Evidence Level III, prognostic study. See Instructions for Authors for a complete description of levels of evidence.

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“…Radiographic evaluation is limited by a lack of consensus regarding criteria, which continue to evolve as the radiographic features of FAI are better understood. The authors of several previous studies have reported differences in FAI deformity and intra-articular pathology between males and females 1,2,[4][5][6][7][8][9] . The purpose of this study was to comprehensively characterize the effect of sex on FAI subtype and on clinical, radiographic, and intraoperative findings in consecutive cohorts of male and female patients with symptomatic FAI.…”

mentioning

confidence: 99%

“…The sex of a patient has been significantly associated with radiographic differences in FAI deformity, the severity of intraarticular disease, and outcomes 1,2,[4][5][6] . Identifying sex-specific disease patterns is important to improving diagnostic and treatment algorithms.…”

mentioning

confidence: 99%

Clinical Presentation and Disease Characteristics of Femoroacetabular Impingement Are Sex-Dependent

Nepple

Riggs

Ross

et al. 2014

The Journal of Bone and Joint Surgery

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Sex Differences of Hip Morphology in Young Adults With Hip Pain and Labral Tears

Cited by 110 publications

References 36 publications

Sex Differences in Cartilage Topography and Orientation of the Developing Acetabulum: Implications for Hip Preservation Surgery

Sex Differences in Cartilage Topography and Orientation of the Developing Acetabulum: Implications for Hip Preservation Surgery

Two or More Impingement and/or Instability Deformities Are Often Present in Patients With Hip Pain

Clinical Presentation and Disease Characteristics of Femoroacetabular Impingement Are Sex-Dependent

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