Lexicon on the Pathomechanics of the Native Hip Joint at Risk for Arthritis

Area of Science:

• Orthopedics
• Biomechanical Engineering
• Medical Terminology

Background:

• Hip osteoarthritis (OA) stems from structural issues affecting load distribution and causing chondrolabral damage.
• Current terminology in hip preservation is inconsistent, hindering scientific communication and treatment standardization.
• A structured lexicon is needed to define morphological features and pathomechanics of the symptomatic, pre-arthritic hip.

Purpose of the Study:

• To develop a structured lexicon for the symptomatic, pre-arthritic hip.
• To link existing literature evidence on morphological features and pathomechanical mechanisms.
• To establish a unified terminology for hip preservation.

Main Methods:

• Synthesized current biomechanical, radiographic, and clinical evidence.
• Incorporated expert consensus from an international, multidisciplinary panel.
• Utilized foundational concepts from tribology, mechanobiology, and contact mechanics.

Main Results:

• Proposed three principal wear modes: instability, impingement, and mixed mechanisms.
• Classified wear mechanisms including rim overload, cartilage failure, shear, rim conflict, and inflammatory degeneration.
• Detailed wear damage classification by tissue involvement and linked lesion topography to underlying mechanics.

Conclusions:

• The developed lexicon offers a coherent framework for pre-arthritic hip disease.
• Establishes shared terminology to guide basic-science research and clinical practice interpretation.
• Enhances understanding and management of hip instability and femoroacetabular impingement.