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Degeneration in dysplastic hips

A Computer tomography study

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Skeletal Radiology Aims and scope Submit manuscript

Abstract

Background

Hip dysplasia is considered pre-osteoarthritic, causing degeneration in young individuals.

Objective

To determine the pattern of degenerative change in moderate to severely dysplastic hips in young patients.

Design and patients

One hundred and ninety-three consecutively-referred younger patients with hip pain believed to be caused by hip dysplasia constituted the study cohort. The average age was 35.5 years (range, 15–61 years). They were examined by close-cut transverse pelvic and knee computed tomography and antero-posterior radiographs (CT). We identified 197 hips with moderate to severe dysplasia, and 78 hips with normal morphology in the study cohort, whilst 111 hip joints were borderline dysplastic according to preset definitions. Comparative analyses of anatomy and distribution of degeneration between dysplastic and normal hips in the study cohort were performed.

Results

In dysplastic hips the anterior acetabular sector angle was significantly and inversely associated to femoral anteversion (p<0.001). The center-edge (CE) angle, the acetabular angle (AA), and the acetabular depth ratio (ADR) were significantly interrelated (p<0.001; correlation coefficients ranging from −0.8 to 0.7). Fifty-one hips were subluxated (24R/27L). There were no cases of complete dislocation. The formation of subchondral cysts or osteophytes in dysplastic hips was significantly associated with reduced minimum joint space width (p ranging from 0.005 to 0.02). However, in 67 hips with acetabular cysts, only 6 hips had minimum joint space widths =2.0 mm (8.9%) in the coronal plane. In 96 cases with acetabular cysts found in the sagittal plane, 43 cases had minimum joint space widths =2.0 mm (44.7%). Bony rim detachment at the site of labral insertion was recorded in 30 hips. Twenty-three of these were dysplastic (p=0.01).

Conclusions

Degeneration was most often found in the anterolateral part of the dysplastic hip joints. Most cysts were located above the transition zone between the bony and the fibrocartilaginous acetabulum, and we found a significantly- increased number of cases with avulsed bony fragments at the antero-lateral labral insertion in dysplastic hips compared to normal hips. It seems likely that the early degenerative process in dysplastic hips originates at the watershed zone between the acetabular labrum and the acetabular cartilage in response to subluxation and femoroacetabular impingement.

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References

  1. Wiberg G. Studies on dysplastic acetabula and congenital subluxation of the hip joint. Acta Orthop Scand Suppl 1939;58:1–132, Stockholm, PA Norstedt and Söner

    Google Scholar 

  2. Stulberg SD. Acetabular dysplasia and development of osteoarthritis of hip. Harris WH, editor. The hip. Proceedings of the second open scientific meeting of the hip society. St.Louis: CV Mosby; 1974. p. 82–93

    Google Scholar 

  3. Afoke NYP, Byers PD, Hutton WC. Contact pressures in the human hip joint. J Bone Joint Surg Br 1987;69:536–41

    PubMed  CAS  Google Scholar 

  4. Bergmann G, Graichen F, Rohlmann A. Hip joint loading during walking and running, measured in two patients. J Biomechanics 1993;26:969–90

    Article  CAS  Google Scholar 

  5. Hadley NA, Brown TD, Weinstein SL. The effects of contact pressure elevations and aseptic necrosis on the long-term outcome of congenital hip dislocation. J Orthop Res 1990;8:504–13

    Article  PubMed  CAS  Google Scholar 

  6. McCarthy JC, Lee JA. Acetabular dysplasia: a paradigm of arthroscopic examination of chondral injuries. Clin Orthop 2002;405:122–8

    Article  PubMed  Google Scholar 

  7. McCarthy JC, Noble PC, Schuck MR, Wright J, Lee J. The watershed labral lesion: its relationship to early arthritis of the hip. J Arthroplasty 2001;16 8 Suppl 1:81–7

    Article  PubMed  CAS  Google Scholar 

  8. Klaue K, Durnin CW, Ganz R. The acetabular rim syndrome. A clinical presentation of dysplasia of the hip. J Bone Joint Surg Br 1991;73:423–9

    PubMed  CAS  Google Scholar 

  9. Sampson TG. Hip morphology and its relationship to pathology: dysplasia to impingement. Oper Tech Sports Med 2005;13:37–45

    Article  Google Scholar 

  10. Lavigne M, Parvizi J, Beck M et al. Anterior femoroacetabular impingement. Clin Orthop 2004;418:61–6

    Article  PubMed  Google Scholar 

  11. Ganz R, Parvizi J, Beck M et al. Femoroacetabular impingement. Clin Orthop 2003;417:111–9

    Google Scholar 

  12. Anda S, Terjesen T, Kvistad KA, Svenningsen S. Acetabular angles and femoral anteversion in dysplastic hips in adults: CT investigation. J Comput Assist Tomogr 1991;15:115–20

    Article  PubMed  CAS  Google Scholar 

  13. Kubo T, Horii M, Yamaguchi J, Inoue S, Fujioka M, Ueshima K et al. Acetabular labrum in hip dysplasia evaluated by radial magnetic resonance imaging. J Rheumatol 2000;27:1955–60

    PubMed  CAS  Google Scholar 

  14. Cooperman DR, Wallensten R, Stulberg SD. Acetabular dysplasia in the adult. Clin Orthop 1983;175:79–85

    PubMed  Google Scholar 

  15. Jacobsen S, Sonne-Holm S. Hip dysplasia: a significant risk factor for the development of hip osteoarthritis. Rheumatology 2005;44:211–8

    Article  PubMed  CAS  Google Scholar 

  16. Jacobsen S, Sonne-Holm S, Søballe K. Hip dysplasia and osteoarthrosis: a survey of 4 151 subjects from the Osteoarthrosis Substudy of the Copenhagen City Heart Study. Acta Orthop 2005;76:149–58

    Article  PubMed  Google Scholar 

  17. Lanyon P, Muir K, Doherty S, Doherty M. Age and sex differences in hip joint space among asymptomatic subjects without structural change: implications for epidemiologic studies. Arthritis Rheum 2003;48:1041–6

    Article  PubMed  Google Scholar 

  18. Yoshida M, Konishi N. Subcondral cysts arise in the anterior acetabulum in dysplastic osteoarthritic hips. Clin Orthop 2002;404:291–301

    Article  PubMed  Google Scholar 

  19. McCarthy J, Noble P, Aluisio FV, Schuck M, Wright J, Lee JA. Anatomy, pathologic features, and treatment of acetabular labral tears. Clin Orthop 2003;406:38–47

    Article  PubMed  Google Scholar 

  20. McCarthy JC, Noble PC, Schuck MR, Wright J, Lee J. The Otto E Aufranc Award: The role of labral lesions to development of early degenerative hip disease. Clin Orthop 2001;393:25–37

    Article  PubMed  Google Scholar 

  21. McCarthy JC, Busconi B. The role of hip arthroscopy in the diagnosis and treatment of hip disease. Can J Surg 1995;38 Suppl 1:S13–7

    PubMed  Google Scholar 

  22. Michaeli DA, Murphy SB, Hipp JA. Comparison of predicted and measured contact pressures in normal and dysplastic hips. Med Eng Phys 1997;19:180–6

    Article  PubMed  CAS  Google Scholar 

  23. Ferguson SJ, Bryant JT, Ganz R, Ito K. The influence of the acetabular labrum on hip joint cartilage consolidation: a poroelastic finite element model. J Biomechanics 2000;33:953–60

    Article  CAS  Google Scholar 

  24. Ferguson SJ, Bryant JT, Ganz R, Ito K. An in vitro investigation of the acetabular labral seal in hip joint mechanics. J Biomechanics 2003;36:171–8

    Article  CAS  Google Scholar 

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Acknowledgements

This study has been financially supported by the Research Board of the National University Hospital of Rigshospitalet, the Danish Medical Research Council, the Danish Rheumatism Association, the SAHVA Foundation, and Sygekassernes Helsefond.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Copenhagen University Hospital Hvidovre, Copenhagen, Denmark

    Steffen Jacobsen

  2. Department of Radiology, Aarhus University Hospital, Aarhus, Denmark

    Lone Rømer

  3. Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus, Denmark

    Kjeld Søballe

  4. Skodsborg strandvej 157 A, II, 2942, Skodsborg, Denmark

    Steffen Jacobsen

Authors
  1. Steffen Jacobsen
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  2. Lone Rømer
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  3. Kjeld Søballe
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Correspondence to Steffen Jacobsen.

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Jacobsen, S., Rømer, L. & Søballe, K. Degeneration in dysplastic hips. Skeletal Radiol 34, 778–784 (2005). https://doi.org/10.1007/s00256-005-0019-7

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  • DOI: https://doi.org/10.1007/s00256-005-0019-7

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