Purpose
To compare the hip morphology of adolescent male patients and female patients who
underwent hip arthroscopy for femoroacetabular impingement (FAI) and determine if
gender differences exist.
Methods
We retrospectively reviewed the records of 177 adolescents, aged 13 to 18 years, who
were treated for FAI with hip arthroscopy. We examined and analyzed preoperative magnetic
resonance imaging (MRI) scans and plain radiographs, measuring the lateral center-edge
angle, Tönnis angle, and alpha angle. The intraclass correlation coefficient between
readers was calculated. We created multiple linear regression models incorporating
age, gender, and body mass index (BMI) with the radiographic measurements. Intraoperative
findings using the Outerbridge grading system, as well as procedure performed, were
documented. We compared these findings with our preoperative imaging measurements
using the χ2 test and the Wilcoxon rank sum test.
Results
The intraclass correlation coefficient showed moderate to strong agreement between
the 3 image readers. The BMI- and age-adjusted mean alpha angle was higher in male
patients than female patients on both plain radiographs (55.9° vs 45.2°, P < .0001) and axial oblique MRI scans (54.1° vs 42.5°, P < .0001). An alpha angle greater than 55° was found in 38.9% of male patients compared
with only 1% of female patients (P < .0001). The lateral center-edge angle and Tönnis angle on MRI scans and plain radiographs
displayed no statistically significant differences between genders after we controlled
for BMI and age. Male patients were more likely to have chondral damage intraoperatively
than female patients (56.3% vs 32.5%, P = .0041).
Conclusions
Distinct differences between genders were seen both on preoperative imaging and at
the time of hip arthroscopy. We found that male patients with FAI displayed a larger
mean alpha angle, and therefore a more severe cam-type deformity, than female patients.
Our study also found that male patients were more likely to show evidence of chondral
damage than female patients at the time of surgery.
Level of Evidence
Level IV.
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Article info
Publication history
Published online: August 08, 2016
Accepted:
June 3,
2016
Received:
January 31,
2016
Footnotes
See commentary on page 2503
The authors report the following potential conflict of interest or source of funding: R.G. receives support from Stryker. J.R. receives support from Smith & Nephew.
Identification
Copyright
© 2016 by the Arthroscopy Association of North America
