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Is hip morphology a risk factor for developing hip osteoarthritis? A systematic review with meta-analysis
N C Casartelli1, N A Maffiuletti2, P L Valenzuela3
1Human Performance Lab, Schulthess Clinic, Zurich, Switzerland; Laboratory of Exercise and Health, ETH Zurich, Schwerzenbach, Switzerland.
Osteoarthritis and Cartilage
|June 25, 2021
Summary
Cam morphology and hip dysplasia significantly increase the risk of developing hip osteoarthritis (OA). Pincer morphology
Area of Science:
- Orthopedics and Sports Medicine
- Radiology
- Rheumatology
Background:
- Hip osteoarthritis (OA) is a prevalent degenerative joint disease.
- Abnormal hip morphology is suspected to be a significant risk factor for OA development.
- Understanding the specific morphological risk factors is crucial for early detection and prevention strategies.
Purpose of the Study:
- To synthesize the highest level of evidence regarding hip morphology as a risk factor for hip OA.
- To evaluate the association between specific radiological hip morphology parameters and the development of hip OA.
Main Methods:
- A systematic meta-analysis of prospective and cross-sectional studies was conducted.
- Studies evaluated the association between radiological hip morphology (cam, pincer, dysplasia, acetabular retroversion) and hip OA.
- Data from 42,831 hips across 25,898 individuals were analyzed, using odds ratios (OR) and 95% confidence intervals (CI).
Main Results:
- Prospective studies revealed that cam morphology (alpha angle >60°) and hip dysplasia (LCEA <25°) significantly increase the risk of developing hip OA (OR=2.52 and OR=2.38, respectively).
- Pincer morphology (LCEA >39°) was not associated with OA development in prospective studies (OR=1.08).
- Cross-sectional studies indicated a higher prevalence of pincer morphology (OR=3.71) and acetabular retroversion (OR=2.65) in individuals with hip OA.
Conclusions:
- Cam morphology and hip dysplasia are consistently linked to the development of hip OA.
- Pincer morphology's association with hip OA is evident in cross-sectional data but not confirmed in prospective studies.
- Heterogeneity in quantifying pincer morphology limits definitive conclusions on its role in hip OA development.
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