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Cam morphology but neither acetabular dysplasia nor pincer morphology is associated with osteophytosis throughout the hip: findings from a cross-sectional study in UK Biobank

Cam morphology but neither acetabular dysplasia nor pincer morphology is associated with osteophytosis throughout the hip: findings from a cross-sectional study in UK Biobank
Cam morphology but neither acetabular dysplasia nor pincer morphology is associated with osteophytosis throughout the hip: findings from a cross-sectional study in UK Biobank
Objectives: to examine whether acetabular dysplasia (AD), cam and/or pincer morphology are associated with radiographic hip osteoarthritis (rHOA) and hip pain in UK Biobank (UKB) and, if so, what distribution of osteophytes is observed.

Design: participants from UKB with a left hip dual-energy X-ray absorptiometry (DXA) scan had alpha angle (AA), lateral centre-edge angle (LCEA) and joint space narrowing (JSN) derived automatically. Cam and pincer morphology, and AD were defined using AA and LCEA. Osteophytes were measured manually and rHOA grades were calculated from JSN and osteophyte measures. Logistic regression was used to examine the relationships between these hip morphologies and rHOA, osteophytes, JSN, and hip pain.

Results: 6,807 individuals were selected (mean age: 62.7; 3382/3425 males/females). Cam morphology was more prevalent in males than females (15.4% and 1.8% respectively). In males, cam morphology was associated with rHOA [OR 3.20 (95% CI 2.41–4.25)], JSN [1.53 (1.24–1.88)], and acetabular [1.87 (1.48–2.36)], superior [1.94 (1.45–2.57)] and inferior [4.75 (3.44–6.57)] femoral osteophytes, and hip pain [1.48 (1.05–2.09)]. Broadly similar associations were seen in females, but with weaker statistical evidence. Neither pincer morphology nor AD showed any associations with rHOA or hip pain.

Conclusions: cam morphology was predominantly seen in males in whom it was associated with rHOA and hip pain. In males and females, cam morphology was associated with inferior femoral head osteophytes more strongly than those at the superior femoral head and acetabulum. Further studies are justified to characterise the biomechanical disturbances associated with cam morphology, underlying the observed osteophyte distribution.
Acetabular dysplasia, Cam, DXA, Epidemiology, Osteoarthritis, Pincer
1063-4584
1521-1529
Faber, Benjamin
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Ebsim, Raja
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Saunders, Fiona R.
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Frysz, Monika
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Gregory, Jennifer S.
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Aspden, Richard M.
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Harvey, Nicholas
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Davey Smith, George
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Cootes, Timothy
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Lindner, Claudia
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Tobias, J.H.
de2ae2cb-8547-475a-98e0-9d5169b8deb7
Faber, Benjamin
85a38e7f-74a4-4ba7-a985-a1cff3392ed0
Ebsim, Raja
fa3d2f2c-9d77-4b95-b0ff-c34b57142381
Saunders, Fiona R.
a51cc79d-0928-4ab6-a479-3972c974670b
Frysz, Monika
bda9e219-ca28-43e4-babd-81f2d91ca3e4
Gregory, Jennifer S.
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Aspden, Richard M.
71d1c790-5d9f-40b4-9130-bf7781b0e0dd
Harvey, Nicholas
ce487fb4-d360-4aac-9d17-9466d6cba145
Davey Smith, George
0de6af8f-976a-477d-a944-a98d0c8c1ebb
Cootes, Timothy
f82f878a-ab1d-426c-9510-afa3f6de7aef
Lindner, Claudia
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Tobias, J.H.
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Faber, Benjamin, Ebsim, Raja, Saunders, Fiona R., Frysz, Monika, Gregory, Jennifer S., Aspden, Richard M., Harvey, Nicholas, Davey Smith, George, Cootes, Timothy, Lindner, Claudia and Tobias, J.H. (2021) Cam morphology but neither acetabular dysplasia nor pincer morphology is associated with osteophytosis throughout the hip: findings from a cross-sectional study in UK Biobank. Osteoarthritis and Cartilage, 29 (11), 1521-1529. (doi:10.1016/j.joca.2021.08.002).

Record type: Article

Abstract

Objectives: to examine whether acetabular dysplasia (AD), cam and/or pincer morphology are associated with radiographic hip osteoarthritis (rHOA) and hip pain in UK Biobank (UKB) and, if so, what distribution of osteophytes is observed.

Design: participants from UKB with a left hip dual-energy X-ray absorptiometry (DXA) scan had alpha angle (AA), lateral centre-edge angle (LCEA) and joint space narrowing (JSN) derived automatically. Cam and pincer morphology, and AD were defined using AA and LCEA. Osteophytes were measured manually and rHOA grades were calculated from JSN and osteophyte measures. Logistic regression was used to examine the relationships between these hip morphologies and rHOA, osteophytes, JSN, and hip pain.

Results: 6,807 individuals were selected (mean age: 62.7; 3382/3425 males/females). Cam morphology was more prevalent in males than females (15.4% and 1.8% respectively). In males, cam morphology was associated with rHOA [OR 3.20 (95% CI 2.41–4.25)], JSN [1.53 (1.24–1.88)], and acetabular [1.87 (1.48–2.36)], superior [1.94 (1.45–2.57)] and inferior [4.75 (3.44–6.57)] femoral osteophytes, and hip pain [1.48 (1.05–2.09)]. Broadly similar associations were seen in females, but with weaker statistical evidence. Neither pincer morphology nor AD showed any associations with rHOA or hip pain.

Conclusions: cam morphology was predominantly seen in males in whom it was associated with rHOA and hip pain. In males and females, cam morphology was associated with inferior femoral head osteophytes more strongly than those at the superior femoral head and acetabulum. Further studies are justified to characterise the biomechanical disturbances associated with cam morphology, underlying the observed osteophyte distribution.

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Accepted/In Press date: 10 August 2021
e-pub ahead of print date: 19 August 2021
Published date: November 2021
Additional Information: Role of the funding source BGF is supported by a Medical Research Council (MRC) clinical research training fellowship (MR/S021280/1). RE, MF, FS are supported, and this work is funded by a Wellcome Trust collaborative award (reference number 209233). CL was funded by the MRC, UK (MR/S00405X/1). NCH acknowledges support from the MRC and NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton. BGF, MF, GDS & JHT work in the MRC Integrative Epidemiology Unit at the University of Bristol, which is supported by the MRC (MC_UU_00,011/1). No funders had any role in the study design, collection, analysis and interpretation of data; in the writing of the manuscript; and in the decision to submit the manuscript for publication.
Keywords: Acetabular dysplasia, Cam, DXA, Epidemiology, Osteoarthritis, Pincer

Identifiers

Local EPrints ID: 451192
URI: http://eprints.soton.ac.uk/id/eprint/451192
ISSN: 1063-4584
PURE UUID: 8b96a6c8-8de4-4963-9e3c-eef99c9a81d9
ORCID for Nicholas Harvey: ORCID iD orcid.org/0000-0002-8194-2512

Catalogue record

Date deposited: 14 Sep 2021 16:31
Last modified: 24 Nov 2021 02:38

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Contributors

Author: Benjamin Faber
Author: Raja Ebsim
Author: Fiona R. Saunders
Author: Monika Frysz
Author: Jennifer S. Gregory
Author: Richard M. Aspden
Author: Nicholas Harvey ORCID iD
Author: George Davey Smith
Author: Timothy Cootes
Author: Claudia Lindner
Author: J.H. Tobias

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