Defining structural abnormalities of the hip joint at risk of degeneration

Vickas Khanna, Paul E Beaulé, Vickas Khanna, Paul E Beaulé

Abstract

The purpose of this review is to explore the mounting evidence that primary osteoarthritis is secondary to childhood disorders such as dysplasia and/or to subtle morphologic and structural to subtle morphologic and structural abnormalities of the proximal femur and/or acetabulum that were previously unrecognized or underestimated. These structural deformities lead to early impingement through range of motion and subsequent joint degeneration. The review also presents a brief synopsis of the genetic components that influence structural morphology of the hip joint and the impact of genetic pathways on OA development. If subtle deformities can be shown to be effective predictors of OA in the general population, it may be possible to identify hips that are at risk before they progress to end-stage OA. Furthermore, if these early risk factors are modifiable, it may be possible to implement preventative measures before the requirement of total hip arthroplasty.

Figures

Figure 1.
Figure 1.
A 28-year-old female with right hip dysplasia showing progression of hip arthritis over a 4-year period.
Figure 2.
Figure 2.
Cam deformity leading to arthritis in a 36-year-old male. Inset shows lack of concavity.
Figure 3.
Figure 3.
Pincer deformity leading to arthritis in a 48-year-old male with anteroposterior radiograph showing retroversion (ischial spine sign). Inset shows normal head/neck concavity.
Figure 4.
Figure 4.
A 39-year-old male with global overcoverage and advanced arthritis of his right hip.
Figure 5.
Figure 5.
Arthritis secondary to Legg–Calve–Perthes in a 33-year-old female. Inset shows grossly aspherical femoral head.

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