Measures of hip morphology are related to development of worsening radiographic hip osteoarthritis over 6 to 13 year follow-up: the Johnston County Osteoarthritis Project.
OBJECTIVE
We sought to describe the effect of alterations in hip morphology with respect to worsening hip OA in a community-based sample including African American (AA) and white men and women.


METHODS
This nested case-control study defined case hips as Kellgren Lawrence grade (KLG) <3 on baseline supine pelvis radiographs and KLG ≥3 or THR for OA at the 1st or 2nd follow-up visit (mean 6 and 13 years, respectively); control hips had KLG <3 at both visits, with gender/race distribution similar to cases. Hip morphology was assessed using HipMorf software (Oxford, UK). Descriptive means and standard errors were obtained from generalized estimating equation (GEE) models. Sex-stratified GEE regression models (accounting for within-person correlation), adjusted for age, race, BMI, and side were then employed.


RESULTS
A total of 120 individuals (239 hips; 71 case/168 control) were included (25% male, 26% AA, mean age 62 years, BMI 30 kg/m(2)). Case hips tended to have greater baseline AP alpha angles, smaller minimum joint space width (mJSW) and more frequent triangular index signs. Adjusted results among men revealed that higher AP alpha angle, Gosvig ratio, and acetabular index were positively associated with case hips; coxa profunda was negatively associated. Among women, greater AP alpha angle, smaller mJSW, protrusio acetabuli, and triangular index sign were associated with case hips.


CONCLUSIONS
We confirmed an increased risk of worsening hip OA due to baseline features of cam deformity among men and women, as well as protrusio acetabuli among women, and provide the first estimates of these measures in AAs.
Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. Electronic address: aenelson@med.unc.edu.
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Nelson
Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. Electronic address: jamie_stiller@med.unc.edu.
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Stiller
SAS Institute, Inc, Cary, NC, USA. Electronic address: amy.shi@sas.com.
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Shi
NIHR Musculoskeletal Biomedical Research Unit and Arthritis Research UK Centre for Sport, Exercise, and Osteoarthritis, University of Oxford, Oxford, UK. Electronic address: kirsten.leyland@ndorms.ox.ac.uk.
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Leyland
Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. Electronic address: jordan_renner@med.unc.edu.
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Renner
Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. Electronic address: tschwart@email.unc.edu.
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Schwartz
NIHR Musculoskeletal Biomedical Research Unit and Arthritis Research UK Centre for Sport, Exercise, and Osteoarthritis, University of Oxford, Oxford, UK. Electronic address: nigel.arden@ndorms.ox.ac.uk.
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Arden
Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Orthopaedics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. Electronic address: joanne_jordan@med.unc.edu.
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Jordan
D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D016022:Case-Control Studies; D018450:Disease Progression; D005260:Female; D057925:Femoracetabular Impingement / Q000150:complications / Q000000981:diagnostic imaging / Q000208:ethnology / Q000473:pathology*; D005500:Follow-Up Studies; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000000981:diagnostic imaging* / Q000208:ethnology / Q000209:etiology / Q000473:pathology*; D011859:Radiography / Q000379:methods; D012720:Severity of Illness Index; D012737:Sex Factors; D044465:White People / Q000706:statistics & numerical data
Femoroacetabular impingement; Hip morphology; Race/sex differences