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Associations between hip cartilage lesions and morphologic parameters of bony structures in a cohort of Asian
Hokuto Fukuda1, Yoichi Murata1, Haruki Nishimura1
1Department of Orthopaedic Surgery, Wakamatsu Hospital of the University of Occupational and Environmental Health, 1-17-1, Hamamachi Wakamatsu, Kitakyushu, Fukuoka, 808-0024, Japan.
Objective:
This study aimed to investigate the associations between hip cartilage lesions and bony morphologic parameters in the hip joints using a computed tomography-based software system.
Methods:
Seventy-nine symptomatic hips that underwent hip arthroscopic labral preservation surgery were enrolled in this study. Bony structural morphologic parameters were subsequently assessed via a computed tomography-based software system. The indices included the femoral neck anteversion (FNA), alpha angle (AA) at each o'clock position of the femoral head, lateral center-edge angle (LCEA), and three-dimensional acetabular coverage (3D-AC). Cartilage damage was confirmed arthroscopically and classified according to the Multicenter Arthroscopy of the Hip Outcome Research Network (MAHORN) classification as well as the International Cartilage Repair Society classification.
Results:
Of the 79 hips, 41 patients were male, and 38 were female, with a mean age of 39.1 years ±16.1 years (11-78). The mean LCEA was 27.6° ± 8.6° (range 7°-46°), and the mean FNA was 22.9° ± 14.4° (range -2°-63°). Grade 4 or 5 MAHORN acetabulum cartilage lesions were observed in 10 hips (13 %), while femoral head cartilage lesions with ICRS grade of 3 or 4 were found in 10 hips. Patients with MAHORN grade 4 or 5 cartilage lesions had significantly greater FNA compared with those with MAHORN grade 0 to 3 lesions (32.6° ± 10.3° versus 21.4° ± 14.4°, p = 0.009). Although patients with MAHORN grade 4 or 5 lesions had greater AA at the entire o'clock of the femoral neck, the difference was not statistically significant. Patients whose FNAs were 26° or larger had a 6.2-fold greater odds ratio (95 % confidence interval, 1.2-31.5) of acetabular cartilage damage than those whose FNAs were less than 26° (p = 0.015).
Conclusion:
The use of computed tomography-based software provided detailed insights into bony abnormalities reinforcing its utility in evaluating hip joint pathologies and their relationship with cartilage lesions.
Level Of Evidence:
Level III.
