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

Benjamin G Faber; R.  Ebsim; Fiona Saunders; Monika Frysz; Jenny Gregory; R M Aspden; Nicholas C Harvey; George Davey Smith; Timothy Cootes; Claudia  Lindner; Jonathan H. Tobias

doi:10.1016/j.joca.2021.08.002

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

Benjamin G Faber^* (Corresponding Author), R. Ebsim, Fiona Saunders, Monika Frysz, Jenny Gregory, R M Aspden, Nicholas C Harvey, George Davey Smith, Timothy Cootes, Claudia Lindner, Jonathan H. Tobias

^*Corresponding author for this work

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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

Original language	English
Pages (from-to)	1521-1529
Number of pages	9
Journal	Osteoarthritis and Cartilage
Volume	29
Issue number	11
Early online date	18 Oct 2021
DOIs	https://doi.org/10.1016/j.joca.2021.08.002
Publication status	Published - Nov 2021

Bibliographical note

Acknowledgements:
The authors would like to thank Dr Martin Williams, Consultant Musculoskeletal Radiologist North Bristol NHS Trust, who provided substantial training and expertise for this study. This work has been conducted using the UK Biobank resource, access application 17295
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_00011/1). 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

Cam
Pincer
Acetabular Dysplasia
DXA
Osteoarthritis
Epidemiology

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Faber_etal_OC_Cam_Morphology_Neither_VOR
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Cite this

Faber, B. G., Ebsim, R., Saunders, F., Frysz, M., Gregory, J., Aspden, R. M., Harvey, N. C., Smith, G. D., Cootes, T., Lindner, C., & 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. https://doi.org/10.1016/j.joca.2021.08.002

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. / Faber, Benjamin G (Corresponding Author); Ebsim, R. ; Saunders, Fiona et al.
In: Osteoarthritis and Cartilage, Vol. 29, No. 11, 11.2021, p. 1521-1529.

Research output: Contribution to journal › Article › peer-review

Faber, BG, Ebsim, R, Saunders, F, Frysz, M, Gregory, J , Aspden, RM, Harvey, NC, Smith, GD, Cootes, T, Lindner, C & Tobias, JH 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, vol. 29, no. 11, pp. 1521-1529. https://doi.org/10.1016/j.joca.2021.08.002

@article{953e0629ccd24f20a2d9b0bcc5da6426,

title = "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",

abstract = "ObjectivesTo 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.DesignParticipants 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.Results6,807 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.ConclusionsCam 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",

keywords = "Cam, Pincer, Acetabular Dysplasia, DXA, Osteoarthritis, Epidemiology",

author = "Faber, {Benjamin G} and R. Ebsim and Fiona Saunders and Monika Frysz and Jenny Gregory and Aspden, {R M} and Harvey, {Nicholas C} and Smith, {George Davey} and Timothy Cootes and Claudia Lindner and Tobias, {Jonathan H.}",

note = "Acknowledgements: The authors would like to thank Dr Martin Williams, Consultant Musculoskeletal Radiologist North Bristol NHS Trust, who provided substantial training and expertise for this study. This work has been conducted using the UK Biobank resource, access application 17295 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_00011/1). 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 ",

year = "2021",

month = nov,

doi = "10.1016/j.joca.2021.08.002",

language = "English",

volume = "29",

pages = "1521--1529",

journal = "Osteoarthritis and Cartilage",

issn = "1063-4584",

publisher = "ELSEVIER APPL SCI PUBL LTD",

number = "11",

}

TY - JOUR

T1 - Cam morphology but neither acetabular dysplasia nor pincer morphology is associated with osteophytosis throughout the hip

T2 - findings from a cross-sectional study in UK Biobank

AU - Faber, Benjamin G

AU - Ebsim, R.

AU - Saunders, Fiona

AU - Frysz, Monika

AU - Gregory, Jenny

AU - Aspden, R M

AU - Harvey, Nicholas C

AU - Smith, George Davey

AU - Cootes, Timothy

AU - Lindner, Claudia

AU - Tobias, Jonathan H.

N1 - Acknowledgements: The authors would like to thank Dr Martin Williams, Consultant Musculoskeletal Radiologist North Bristol NHS Trust, who provided substantial training and expertise for this study. This work has been conducted using the UK Biobank resource, access application 17295 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_00011/1). 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

PY - 2021/11

Y1 - 2021/11

N2 - ObjectivesTo 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.DesignParticipants 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.Results6,807 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.ConclusionsCam 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

AB - ObjectivesTo 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.DesignParticipants 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.Results6,807 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.ConclusionsCam 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

KW - Cam

KW - Pincer

KW - Acetabular Dysplasia

KW - DXA

KW - Osteoarthritis

KW - Epidemiology

U2 - 10.1016/j.joca.2021.08.002

DO - 10.1016/j.joca.2021.08.002

M3 - Article

SN - 1063-4584

VL - 29

SP - 1521

EP - 1529

JO - Osteoarthritis and Cartilage

JF - Osteoarthritis and Cartilage

IS - 11

ER -

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

Abstract

Bibliographical note

Keywords

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