Subregional statistical shape modelling identifies lesser trochanter size as a possible risk factor for radiographic hip osteoarthritis, a cross-sectional analysis from the Osteoporotic Fractures in Men Study

BG Faber* (Corresponding Author), TL Bredbenner , Denis Baird, J Gregory, Fiona Saunders, CV Giuraniuc, RM Aspden, NE Lane, Eric Orwoll, JH Tobias

*Corresponding author for this work

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Abstract

Objective
Statistical shape modelling (SSM) of hip dual-energy x-ray absorptiometry (DXA) scans has identified relationships between hip shape and radiographic hip OA (rHOA). We aimed to further elucidate shape characteristics related to rHOA by focusing on subregions identified from whole-hip shape models.
Design
SSM was applied to hip DXAs obtained in the Osteoporotic Fractures in Men Study. Whole-hip shape modes (HSMs) associated with rHOA were combined to form a composite at-risk-shape. Subsequently, subregional HSMs (cam-type and lesser trochanter modes) were built, and associations with rHOA were examined by logistic regression. Subregional HSMs were further characterised, by examining associations with 3D-HSMs derived from concurrent hip CT scans.
Results
4098 participants were identified with hip DXAs and radiographs. Composite shapes from whole-hip HSMs revealed that lesser trochanter size and cam-type femoral head are related to rHOA. From sub-regional models, lesser trochanter mode (LTM)1 [OR 0.74; 95%CI 0.63,0.87] and cam-type mode (CTM)3 [OR 1.27;1.13,1.42] were associated with rHOA, associations being similar to those for whole hip HSMs. 515 MrOS participants had hip DXAs and 3D-HSMs derived from hip CT scans. LTM1 was associated with 3D-HSMs that also represented a larger lesser trochanter [3D-HSM7 (beta (β)-0.23;-0.33,-0.14) and 3D-HSM9 (β0.36;0.27,0.45)], and CTM3 with 3D-HSMs describing cam morphology [3D-HSM3 (β-0.16;-0.25,-0.07) and 3D-HSM6 (β 0.19;0.10,0.28)].
Conclusion
Subregional SSM of hip DXA scans suggested larger lesser trochanter and cam morphology underlie associations between overall hip shape and rHOA. 3D hip modelling suggests our subregional SSMs represent true anatomical variations in hip shape, warranting further investigation.
Original languageEnglish
Pages (from-to)1071-1078
Number of pages8
JournalOsteoarthritis and Cartilage
Volume28
Issue number8
Early online date7 May 2020
DOIs
Publication statusPublished - 1 Aug 2020

Bibliographical note

BGF was a National Institute of Health Research academic clinical fellow whilst undertaking part of this research and is now a Medical Research Council clinical research fellow supported by grant MR/S021280/1. FRS was supported by a Medical Research Council UK grant MR/L010399/1 at the time of this study. This study used the SSM cohort funded by Versus Arthritis UK project grant ref 20244. The Osteoporotic Fractures in Men (MrOS) Study is supported by National Institutes of Health funding. The following institutes provide support: the National Institute on Aging (NIA), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), the National Center for Advancing Translational Sciences (NCATS), and NIH Roadmap for Medical Research under the following grant numbers: R01 AR052000, K24 AR048841, U01 AG027810, U01 AG042124, U01 AG042139, U01 AG042140, U01 AG042143, U01 AG042145, U01 AG042168, U01 AR066160, and UL1 TR000128. Partial support for this work was provided by the Southwest Research Institute internal research project R9541 and NIAMS research grant AR052013.

All authors have made significant contributions to the conception and design of this study, the acquisition of data, its analysis and interpretation. All authors helped draft the article before approving the final version of this manuscript. Dr B Faber (ben.faber@bristol.ac.uk) takes responsibility for the integrity of the work in its entirety.

Keywords

  • osteoarthritis
  • hip shape
  • statistical shape modelling
  • epidemiology
  • Hip shape
  • Statistical shape modelling
  • Epidemiology
  • Osteoarthritis

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