The association between statistical shape modeling-defined hip morphology and features of early hip osteoarthritis in young adult football players: Data from the femoroacetabular impingement and hip osteoarthritis cohort (FORCe) study

M M A van Buuren; J J Heerey; A Smith; K M Crossley; J L Kemp; M J Scholes; P R Lawrenson; M G King; W P Gielis; H Weinans; C Lindner; R B Souza; J A N Verhaar; R Agricola

doi:10.1016/j.ocarto.2022.100275

The association between statistical shape modeling-defined hip morphology and features of early hip osteoarthritis in young adult football players: Data from the femoroacetabular impingement and hip osteoarthritis cohort (FORCe) study

Osteoarthr Cartil Open. 2022 May 20;4(3):100275. doi: 10.1016/j.ocarto.2022.100275. eCollection 2022 Sep.

Authors

M M A van Buuren¹, J J Heerey², A Smith³, K M Crossley², J L Kemp², M J Scholes², P R Lawrenson⁴, M G King², W P Gielis⁵, H Weinans^{5

6}, C Lindner⁷, R B Souza⁸, J A N Verhaar¹, R Agricola¹

Affiliations

¹ Department of Orthopaedics and Sports Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
² La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia.
³ School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia.
⁴ School of Health & Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.
⁵ Department of Orthopaedics, University Medical Center Utrecht, Utrecht, the Netherlands.
⁶ Department of Biomechanical Engineering, Delft University of Technology, Delft, the Netherlands.
⁷ Division of Informatics, Imaging & Data Sciences, University of Manchester, Manchester, United Kingdom.
⁸ Department of Physical Therapy and Rehabilitation Science, University of California San Francisco, San Francisco, CA, USA.

Abstract

Objective: To explore the relationship between radiographic hip shape and features of early hip osteoarthritis (OA) on magnetic resonance imaging (MRI) in young male and female football players without radiographic hip OA.

Design: We used baseline data from a cohort of symptomatic and asymptomatic football players aged 18-50 years. Hip shape was assessed on anteroposterior radiographs with statistical shape modeling (SSM) for men and women separately. Cartilage defects and labral tears were graded using the Scoring Hip Osteoarthritis with MRI (SHOMRI) system. We used logistic regression with generalized estimating equations to estimate associations between each hip shape variant, called shape modes, and cartilage defects or labral tears.

Results: We included 229 participants (446 hips, 77.4% male). For each sex, 15 shape modes were analyzed. In men, three shape modes were associated with cartilage defects: adjusted odds ratios (aOR) 0.75 (95%CI 0.58-0.97) per standard deviation (SD) for mode 1; 1.34 (95%CI 1.05-1.69) per SD for mode 12; and 0.61 (95%CI 0.48-0.78) per SD for mode 15; and one also with labral tears: aOR 1.30 (95%CI 1.01-1.69) per SD for mode 12. These modes generally represented variations in the femoral neck and subtypes of cam morphology, with and without pincer morphology. For women, there was no evidence for associations with the outcomes.

Conclusions: Several hip shape variants were associated with cartilage defects on MRI in young male football players. Specifically, one subtype of cam morphology was associated with both cartilage defects and labral tears. Hip shape was not associated with early OA features in women.

Keywords: Femoroacetabular impingement; Football; Hip morphology; Hip osteoarthritis; Magnetic resonance imaging; Statistical shape modeling.

Grants and funding

MR/S00405X/1/MRC_/Medical Research Council/United Kingdom