TY - JOUR
T1 - Risk Factors for Long-term Hip Osteoarthritis in Patients With Femoroacetabular Impingement Without Surgical Intervention
AU - Melugin, Heath P.
AU - Hale, Rena F.
AU - Zhou, Jun
AU - LaPrade, Matthew
AU - Bernard, Christopher
AU - Leland, Devin
AU - Levy, Bruce A.
AU - Krych, Aaron J.
N1 - Funding Information:
One or more of the authors has declared the following potential conflict of interest or source of funding: This study was partially funded by the National Institutes of Health (NIH) under grants T32AR056950 as well as Jiangsu Health International Exchange Program (JSH-2018-004), and Grant Number UL1 TR002377 from the National Center for Advancing Translational Sciences (NCATS). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH. A.J.K. has received IP royalties from Arthrex; consulting fees from Arthrex, JRF Ortho, DePuy, and Vericel; research support from Aesculap/B.Braun, Arthritis Foundation, Ceterix, Exactech, Gemini Medical, and Histogenics; and honoraria from Musculoskeletal Transplant Foundation; and he is a shareholder in Responsive Arthroscopy. B.A.L. has received IP royalties from Arthrex; consulting fees from Arthrex and Smith & Nephew; research support from Biomet, Smith & Nephew, and Stryker; and speaking fees from Linvatec. M.L. has a family member who receives royalties from Arthrex, Ossur, and Smith & Nephew and receives consulting fees from Arthrex, Linvatec, Ossur, and Smith & Nephew. H.P.M. has received hospitality payments from DePuy Synthes Sales. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.
Funding Information:
The authors thank Dr Zhefeng Chen, MD, of the Department of Orthopedic Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China, for his advice regarding the measurement and evaluation of radiographs.
Publisher Copyright:
© 2020 The Author(s).
PY - 2020/10/1
Y1 - 2020/10/1
N2 - Background: Femoroacetabular impingement (FAI) is a common cause of hip pain and a known risk factor for hip osteoarthritis (OA) and total hip arthroplasty (THA) at a young age. Unfortunately, little is known about the specific factors associated with an increased risk of OA. Purpose: To (1) report the overall rate of symptomatic hip OA and/or THA in patients with FAI without surgical intervention and (2) identify radiographic features and patient characteristics associated with hip OA. Study Design: Case-control study; Level of evidence, 3. Methods: A geographic database was used to identify all patients with hip pain and radiographs between 2000 and 2016. Chart review was performed to identify patients with FAI. Patient medical records were reviewed to obtain demographic information, clinical history, physical examination findings, imaging details, and treatment details. Kaplan-Meier analysis was used to determine the rate of hip OA. Univariate and multivariate proportional hazard regression models were performed to determine risk factors for OA. Results: The study included 952 patients (649 female; 303 male; 1104 total hips) with FAI. The majority of hips had mixed type (n = 785; 71.1%), 211 (19.1%) had pincer type, and 108 (9.8%) had cam type. Mean age at time of presentation was 27.6 ± 8.7 years. Mean follow-up time was 24.7 ± 12.5 years. The rate of OA was 13.5%. THA was performed in 4% of patients. Male sex, body mass index (BMI) greater than 29, and increased age were risk factors for OA (male sex: hazard ratio [HR], 2.28; P '.01; BMI '29: HR, 2.11; P '.01; per year of increased age: HR, 1.11; P '.01.). Smoking and diabetes mellitus were not significant risk factors. No radiographic morphological features were found to be significant risk factors for OA. Conclusion: At mean follow-up of 24.7 years, 14% of hips had symptomatic OA and 4% underwent THA. BMI greater than 29, male sex, and increased age at the time of presentation with hip pain were risk factors for hip OA. The cohort consisted of a large percentage of mixed-type FAI morphologies, and no specific radiographic risk factors for OA were identified.
AB - Background: Femoroacetabular impingement (FAI) is a common cause of hip pain and a known risk factor for hip osteoarthritis (OA) and total hip arthroplasty (THA) at a young age. Unfortunately, little is known about the specific factors associated with an increased risk of OA. Purpose: To (1) report the overall rate of symptomatic hip OA and/or THA in patients with FAI without surgical intervention and (2) identify radiographic features and patient characteristics associated with hip OA. Study Design: Case-control study; Level of evidence, 3. Methods: A geographic database was used to identify all patients with hip pain and radiographs between 2000 and 2016. Chart review was performed to identify patients with FAI. Patient medical records were reviewed to obtain demographic information, clinical history, physical examination findings, imaging details, and treatment details. Kaplan-Meier analysis was used to determine the rate of hip OA. Univariate and multivariate proportional hazard regression models were performed to determine risk factors for OA. Results: The study included 952 patients (649 female; 303 male; 1104 total hips) with FAI. The majority of hips had mixed type (n = 785; 71.1%), 211 (19.1%) had pincer type, and 108 (9.8%) had cam type. Mean age at time of presentation was 27.6 ± 8.7 years. Mean follow-up time was 24.7 ± 12.5 years. The rate of OA was 13.5%. THA was performed in 4% of patients. Male sex, body mass index (BMI) greater than 29, and increased age were risk factors for OA (male sex: hazard ratio [HR], 2.28; P '.01; BMI '29: HR, 2.11; P '.01; per year of increased age: HR, 1.11; P '.01.). Smoking and diabetes mellitus were not significant risk factors. No radiographic morphological features were found to be significant risk factors for OA. Conclusion: At mean follow-up of 24.7 years, 14% of hips had symptomatic OA and 4% underwent THA. BMI greater than 29, male sex, and increased age at the time of presentation with hip pain were risk factors for hip OA. The cohort consisted of a large percentage of mixed-type FAI morphologies, and no specific radiographic risk factors for OA were identified.
KW - FAI
KW - femoroacetabular impingement
KW - hip pain
KW - osteoarthritis
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U2 - 10.1177/0363546520949179
DO - 10.1177/0363546520949179
M3 - Article
C2 - 32822223
AN - SCOPUS:85089685338
SN - 0363-5465
VL - 48
SP - 2881
EP - 2886
JO - The Journal of sports medicine
JF - The Journal of sports medicine
IS - 12
ER -