senior games poster 2014_0304_mba
TRANSCRIPT
Discussion and Conclusions
Introduc0on Results It is unknown if morphological abnormali5es of the hip are compa5ble with life-‐long hip func5on and avoidance of osteoarthri5s (OA).
Our purpose was to inves5gate the prevalence of radiographic findings consistent with developmental dysplasia of the hip (DDH) and femoroacetabular impingement (FAI) in senior athletes with well-‐func5oning hips. Pa0ents and Methods
The Prevalence of Hip Morphologic Abnormali0es in a Highly Ac0ve
Senior Popula0on University of Utah Orthopaedics, Salt Lake City, Utah
Lucas Anderson MD, Ashley Kapron Phd, Stephen Aoki MD, Jesse Chrastil MD, Mike B. Anderson MS ATC,
Ray Grijalva MD, Jill Erickson PA-‐C, Christopher L. Peters MD
Disclosures are listed in the AAOS program and website. There are no conflicts with this topic.
Overall Hip Morphology
Pa5ents with OA were more likely to have radiographic features of FAI • OR 3.7, 95% CI 1.6 – 8.8, p=0.003
Male pa5ents were more likely to have radiographic features of FAI • OR 10.7, 95% CI 5.4 – 21.1, p<0.001
Breakdown of OA by hip morphology
Breakdown of subjects with FAI
DDH Lateral Center Edge Angle (LCEA) < 20°
Cam FAI Alpha angle (AA) ≥50° on Frog-‐Leg Lateral or AP views
Pincer FAI LCEA > 39°, Acetabular Index (AI) < 0° and/or cross-‐over sign present
OA Tönnis Grade 2 or 3
• 55% Male, Mean Age 67 yrs (50-‐91 yrs) • 93% Caucasian • 5 hips excluded (prior THA or Fx)
1087 Na5ve Hip X-‐rays were reviewed from 546 Senior Athletes at the Huntsman World Senior Games (St. George, Utah)
Radiographic Measures and Associated Cutoffs to Determine Prevalence of Hip Pathomorphology
Morphologic abnormali5es (91%), par5cularly FAI (82%), were more prevalent than an5cipated in these senior athletes.
Rate of radiographic osteoarthri5s was rela5vely low (16%) but strongly correlated with FAI.
While radiographic prevalence of FAI is high (82%) only 20% of FAI hips showed signs of Tönnis grade 2 or 3.
While FAI and dysplasia have historically been associated with development of early OA, this study suggests that there may be other factors, such as gene5cs and car5lage type, which may play a joint preserving role despite presence of pathomorphology in this series of high func5oning senior athletes.
91% of hips had radiographic features of pathomorphology
Histogram shows different historical cutoffs yield varied prevalences of cam FAI.