Purpose
To compare the prevalence of femoroacetabular impingement (FAI) radiographic findings
between patients aged younger than 50 years and those aged 50 years or older who underwent
total hip arthroplasty.
Methods
Total hip arthroplasty patients aged younger than 50 years and those aged 50 years
or older were identified retrospectively from a facility medical record database.
Fifty patients from each group were randomly selected, and preoperative radiographs
were collected. Dysplastic, inflammatory, post-traumatic, and osteonecrosis patients
were excluded. Radiographs were evaluated for FAI-specific findings. Intraobserver
and interobserver reliability was evaluated with κ statistics for categorical variables
and intraclass correlation coefficients for continuous variables. An independent t test was used to compare continuous variables, χ2 analysis was used for discrete variables, and a z ratio was used to analyze proportions.
Results
The mean age between the subgroups of patients aged younger than 50 years and those
aged 50 years or older (43 years and 68 years, respectively) was significantly different
(P < .05). Findings in the subgroup aged younger than 50 years included significantly
more men (P < .001), decreased lateral joint space with maintained medial joint space (P < .05), significantly greater alpha angle on both the anteroposterior view and the
frog-leg lateral view (P < .05), significantly higher Tönnis and Sharp angles (P < .01), and significantly lower center-edge angle (P < .001).
Conclusions
This retrospective case series shows an increased prevalence of FAI findings (specifically
cam pathology) in a patient population aged younger than 50 years undergoing total
hip arthroplasty when compared with a cohort aged 50 years or older.
Level of Evidence
Level III, retrospective comparative study.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to ArthroscopyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Femoroacetabular impingement.J Am Acad Orthop Surg. 2007; 15: 561-570
- Radiographic structural abnormalities associated with premature, natural hip-joint failure.J Bone Joint Surg Am. 2011; 93: 3-9
- AOA symposium. Hip disease in the young adult: Current concepts of etiology and surgical treatment.J Bone Joint Surg Am. 2008; 90: 2267-2281
- Femoroacetabular impingement: A cause for osteoarthritis of the hip.Clin Orthop Relat Res. 2003; : 112-120
- The etiology of osteoarthritis of the hip: An integrated mechanical concept.Clin Orthop Relat Res. 2008; 466: 264-272
- Is hip arthroscopy cost-effective for femoroacetabular impingement?.Clin Orthop Relat Res. 2012; 470: 1079-1089
- Prevalence of radiographic findings thought to be associated with femoroacetabular impingement in a population-based cohort of 2081 healthy young adults.Radiology. 2011; 260: 494-502
- Prevalence of abnormal hip findings in asymptomatic participants: A prospective, blinded study.Am J Sports Med. 2012; 40: 2720-2724
- The concept of femoroacetabular impingement: Current status and future perspectives.Clin Orthop Relat Res. 2009; 467: 616-622
- A systematic approach to the plain radiographic evaluation of the young adult hip.J Bone Joint Surg Am. 2008; 90: 47-66
- Effect of pelvic tilt on acetabular retroversion: A study of pelves from cadavers.Clin Orthop Relat Res. 2003; : 241-248
- Imaging of femoroacetabular impingement.J Bone Joint Surg Am. 2009; 91: 138-143
- Conventional radiographs to assess femoroacetabular impingement.Instr Course Lect. 2009; 58: 203-212
- Methods of measuring in Legg-Calve-Perthes disease with special regard to the prognosis.Clin Orthop Relat Res. 1980; : 103-109
- Acetabular dysplasia—The acetabular angle.J Bone Joint Surg Br. 1961; 43: 268-272
- Studies on dysplastic acetabula and congenital subluxation of the hip joint.Acta Chir Scand. 1939; 83: 7-135
- Hip morphology influences the pattern of damage to the acetabular cartilage: Femoroacetabular impingement as a cause of early osteoarthritis of the hip.J Bone Joint Surg Br. 2005; 87: 1012-1018
- Acetabular cartilage delamination in femoroacetabular impingement. Risk factors and magnetic resonance imaging diagnosis.J Bone Joint Surg Am. 2009; 91: 305-313
- The aetiology of primary osteoarthritis of the hip.Br J Radiol. 1965; 38: 810-824
- Clinical and radiographic predictors of intra-articular hip disease in arthroscopy.Am J Sports Med. 2011; 39: 296-303
- Relationship between offset angle alpha and hip chondral injury in femoroacetabular impingement.Arthroscopy. 2008; 24: 669-675
- Anteroposterior pelvic radiographs to assess acetabular retroversion: High validity of the “cross-over-sign.”.J Orthop Res. 2007; 25: 758-765
- The ischial spine sign: Does pelvic tilt and rotation matter?.Clin Orthop Relat Res. 2010; 468: 769-774
Article Info
Publication History
Accepted:
April 16,
2013
Received:
October 10,
2012
Footnotes
The authors report that they have no conflicts of interest in the authorship and publication of this article.
Identification
Copyright
© 2013 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
