A Study on Imaging Risk Factors for Hip Osteoarthritis

Abstract

Objective: Due to low prevalence and few studies, the morphologic risk factors for hip osteoarthritis (HOA) in Chinese population remain unknown. The purpose of this study was to investigate the relationship between 10 radiographic parameters measured via anteroposterior pelvic X-ray radiography and HOA in Chinese population.

Methods: Thirty-three patients who required total hip arthroplasty for unilateral HOA (2017–2022) and 132 healthy individuals were selected for this case–control study. We measured 10 radiological parameters via anteroposterior pelvic X-ray radiography, which were sharp angle, center edge angle, sourcil angle, neck shaft angle, α angle, pelvic height, pelvic width, femoral head diameter, femoral neck width, and ratio of the femoral head diameter to the femoral neck width. After measurements were obtained, logistic regression analysis was utilized to calculate the adjusted odds ratios (ORs) for confounding variables such as age, sex, and body mass index (BMI). Receiver operating characteristic (ROC) curves were utilized to determine the proportional risk contribution (PRC) of each radiographic factor.

Results: After adjustment for confounding factors, individuals with a larger sourcil angle (SA) (OR = 4.89, 95% CI 1.66–14.42, p = 0.004), larger α angle (OR = 4.14, 95% CI 1.53–11.23, p = 0.005), and wider femoral neck (OR = 5.27, 95% CI 1.50–18.51, p = 0.01) were found to have a greater risk of developing HOA. Among all radiographic parameters, the SA demonstrated the greatest risk contribution (PRC = 13.695%).

Conclusions: Radiographic parameters correlate with the incidence of HOA. The SA is probably the most powerful of all the parameters related to HOA.

Keywords

Hip Osteoarthritis / Imaging / Morphological Feature / Pathogenesis

References

[1] Lespasio MJ, Sultan AA, Piuzzi NS, Khlopas A, Husni ME, Muschler GF, et al. Hip osteoarthritis: a primer. Perm J. 2018; 22: 17–84.

[2] Yau MS, Okoro PC, Haugen IK, Lynch JA, Nevitt MC, Lewis CE, et al. Assessing the association of epigenetic age acceleration with osteoarthritis in the multicenter osteoarthritis study (MOST). Osteoarthr Cartil. 2024; 32: 585–591.

[3] Hall M, van der Esch M, Hinman RS, Peat G, de Zwart A, Quicke JG, et al. How does hip osteoarthritis differ from knee osteoarthritis? Osteoarthr Cartil. 2022; 30: 32–41.

[4] Tang J, van Buuren MMA, Riedstra NS, Boel F, Runhaar J, Bierma-Zeinstra S, et al. Cam morphology is strongly and consistently associated with development of radiographic hip osteoarthritis throughout 4 follow-up visits within 10 years. Osteoarthr Cartil. 2023; 31: 1650–1656.

[5] Casartelli NC, Maffiuletti NA, Valenzuela PL, Grassi A, Ferrari E, van Buuren MMA, et al. Is hip morphology a risk factor for developing hip osteoarthritis? A systematic review with meta-analysis. Osteoarthr Cartil. 2021; 29: 1252–1264.

[6] Gielis WP, Weinans H, Welsing PMJ, van Spil WE, Agricola R, Cootes TF, et al. An automated workflow based on hip shape improves personalized risk prediction for hip osteoarthritis in the CHECK study. Osteoarthr Cartil. 2020; 28: 62–70.

[7] Doherty M, Courtney P, Doherty S, Jenkins W, Maciewicz RA, Muir K, et al. Nonspherical femoral head shape (pistol grip deformity), neck shaft angle, and risk of hip osteoarthritis: a case-control study. Arthritis Rheum. 2008; 58: 3172–3182.

[8] Iidaka T, Muraki S, Oka H, Horii C, Kawaguchi H, Nakamura K, et al. Incidence rate and risk factors for radiographic hip osteoarthritis in Japanese men and women: a 10-year follow-up of the ROAD study. Osteoarthr Cartil. 2020; 28: 182–188.

[9] Abdulrahim H, Jiao Q, Swain S, Sehat K, Sarmanova A, Muir K, et al. Constitutional morphological features and risk of hip osteoarthritis: a case-control study using standard radiographs. Ann Rheum Dis. 2021; 80: 494–501.

[10] Li H, Wang Y, Oni JK, Qu X, Li T, Zeng Y, et al. The role of femoral neck anteversion in the development of osteoarthritis in dysplastic hips. Bone Joint J. 2014; 96-b: 1586–1593.

[11] Hunter DJ, Bierma-Zeinstra S. Osteoarthritis. Lancet. 2019; 393: 1745–1759.

[12] Aimi Asyrani Zamri N, Harith S, Mohd Yusoff NA, Mat Hassan N, Ong YQ. Prevalence, risk factors and primary prevention of osteoarthritis in Asia: a scoping review. Elderly Health J. 2019; 5: 19–31.

[13] McWilliams DF, Doherty SA, Jenkins WD, et al. Mild acetabular dysplasia and risk of osteoarthritis of the hip: a case-control study. Ann Rheum Dis. 2010; 69: 1774–1778.

[14] Croft P, Cooper C, Wickham C, Coggon D. Defining osteoarthritis of the hip for epidemiologic studies. Am J Epidemiol. 1990; 132: 514–522.

[15] Materialise NV Technologielaan B. http://www.materialise.com/.

[16] Sarmanova A, Fernandes GS, Richardson H, Valdes AM, Walsh DA, Zhang W, et al. Contribution of central and peripheral risk factors to prevalence, incidence and progression of knee pain: a community-based cohort study. Osteoarthr Cartil. 2018; 26: 1461–1473.

[17] Amstutz HC, Le Duff MJ. The natural history of osteoarthritis: what happens to the other hip? Clin Orthop Relat Res. 2016; 474: 1802–1809.

[18] Bouyer B, Mazieres B, Guillemin F, Bouttier R, Fautrel B, Morvan J, et al. Association between hip morphology and prevalence, clinical severity and progression of hip osteoarthritis over 3 years: the knee and hip osteoarthritis long-term assessment cohort results. Joint Bone Spine. 2016; 83: 432–438.

[19] Faber BG, Ebsim R, Saunders FR, Frysz M, Gregory JS, Aspden RM, et al. Cam morphology but neither acetabular dysplasia nor pincer morphology is associated with osteophytosis throughout the hip: findings from a cross-sectional study in UK biobank. Osteoarthr Cartil. 2021; 29: 1521–1529.

[20] Reichenbach S, Leunig M, Werlen S, Nüesch E, Pfirrmann CW, Bonel H, et al. Association between cam-type deformities and magnetic resonance imaging-detected structural hip damage: a cross-sectional study in young men. Arthritis Rheum. 2011; 63: 4023–4030.

[21] Faber BG, Frysz M, Tobias JH. Unpicking observational relationships between hip shape and osteoarthritis: hype or hope? Curr Opin Rheumatol. 2020; 32: 110–118.

[22] Bittersohl B, Steppacher S, Haamberg T, Kim YJ, Werlen S, Beck M, et al. Cartilage damage in femoroacetabular impingement (FAI): preliminary results on comparison of standard diagnostic vs delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC). Osteoarthr Cartil. 2009; 17: 1297–1306.

[23] Tu LA, Weinberg DS, Liu RW. The association between femoral neck shaft angle and degenerative disease of the hip in a cadaveric model. Hip Int. 2022; 32: 634–640.

[24] Ranawat CS, Dorr LD, Inglis AE. Total hip arthroplasty in protrusio acetabuli of rheumatoid arthritis. J Bone Joint Surg Am. 1980; 62: 1059–1065.

[25] Jang SJ, Kunze KN, Vigdorchik JM, Jerabek SA, Mayman DJ, Sculco PK. John Charnley award: deep learning prediction of hip joint center on standard pelvis radiographs. J Arthroplasty. 2022; 37: S400–S407.e401.

[26] Thomas GE, Palmer AJ, Batra RN, et al. Subclinical deformities of the hip are significant predictors of radiographic osteoarthritis and joint replacement in women. A 20 year longitudinal cohort study. Osteoarthr Cartil. 2014; 22: 1504–1510.

[27] Bowman KF Jr, Fox J, Sekiya JK. A clinically relevant review of hip biomechanics. Arthroscopy. 2010; 26: 1118–1129.

[28] Yang G, Zhang Z, Hou X, Luo D, Cheng H, Xiao K, et al. A new parameter of hip instability in developmental dysplasia of the hip (DDH): teardrop distance. Front Surg. 2022; 9: 899960.

[29] Ahedi HG, Aspden RM, Blizzard LC, Saunders FR, Cicuttini FM, Aitken DA, et al. Hip shape as a predictor of osteoarthritis progression in a prospective population cohort. Arthritis Care Res. 2017; 69: 1566–1573.

RIGHTS & PERMISSIONS

2024 The Author(s). Orthopaedic Surgery published by Tianjin Hospital and John Wiley & Sons Australia, Ltd.