Sex differences of hip morphology in young adults with hip pain and labral tears

Iftach Hetsroni, Katrina Dela Torre, Gavin Duke, Leonard Lyman Stephen, Bryan T. Kelly

Research output: Contribution to journalArticle

52 Citations (Scopus)

Abstract

Purpose: To compare hip morphology between young men and women who presented with hip pain and labral tears. Methods: A retrospective review of our hip arthroscopy registry from March 2008 to June 2010 was completed. We identified 217 patients (249 hips) who were between the ages of 18 to 30 years. The inclusion criteria were (1) insidious-onset hip pain or worsening pain after low-energy sports trauma, (2) positive hip impingement sign, (3) Tönnis grades 0 to 1, (4) magnetic resonance imaging showing labral tear, and (5) primary hip arthroscopy confirming labral tear. Forty-five patients (52 hips) were excluded for the following reasons: (1) revision hip arthroscopy, (2) high-energy hip trauma, (3) history of surgery involving the femur or pelvis, (4) previous fractures of the femur or pelvis, (5) Tönnis grades 2 or above, (6) proliferative disease of the hip (i.e., synovial chondromatosis, pigmented villonodular synovitis), (7) neuromuscular disease (i.e., cerebral palsy), and (8) deformities related to Legg-Calvé-Perthes disease or developmental dysplasia of the hip. Therefore, the cohort study group included 105 (61%) men (123 [62.4%] hips) and 67 (39%) women (74 [37.6%] hips). Sex comparisons were made for the following variables measured on preoperative hip computed tomography scans: alpha angle, acetabular version, femoral version, lateral center-edge angle, and neck-shaft angle. Results: Women had smaller alpha angles (47.8° v 63.6°, P <.001), increased acetabular version (17.3° v 13.9°, P <.001), and increased femoral anteversion (14.4° v 12.1°, P =.05). Conclusions: In young adults with hip pain and labral tears, women have smaller alpha angles and hips that are generally more anteverted. Therefore, in women, cam lesions may be more subtle, preoperative hip version analyses should be encouraged, and rim trimming may need to be cautiously planned to avoid increasing contact stresses at weight-bearing areas after such a procedure. Level of Evidence: Level III, retrospective comparative study.

Original languageEnglish
Pages (from-to)54-63
Number of pages10
JournalArthroscopy - Journal of Arthroscopic and Related Surgery
Volume29
Issue number1
DOIs
Publication statusPublished - Jan 1 2013

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Tears
Sex Characteristics
Hip
Young Adult
Pain
Arthroscopy
Thigh
Pelvis
Femur
Synovial Chondromatosis
Pigmented Villonodular Synovitis
Legg-Calve-Perthes Disease
Neuromuscular Diseases
Hip Dislocation
Wounds and Injuries
Weight-Bearing
Cerebral Palsy
Sports
Registries

All Science Journal Classification (ASJC) codes

  • Orthopedics and Sports Medicine

Cite this

Sex differences of hip morphology in young adults with hip pain and labral tears. / Hetsroni, Iftach; Dela Torre, Katrina; Duke, Gavin; Lyman Stephen, Leonard; Kelly, Bryan T.

In: Arthroscopy - Journal of Arthroscopic and Related Surgery, Vol. 29, No. 1, 01.01.2013, p. 54-63.

Research output: Contribution to journalArticle

Hetsroni, Iftach ; Dela Torre, Katrina ; Duke, Gavin ; Lyman Stephen, Leonard ; Kelly, Bryan T. / Sex differences of hip morphology in young adults with hip pain and labral tears. In: Arthroscopy - Journal of Arthroscopic and Related Surgery. 2013 ; Vol. 29, No. 1. pp. 54-63.
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abstract = "Purpose: To compare hip morphology between young men and women who presented with hip pain and labral tears. Methods: A retrospective review of our hip arthroscopy registry from March 2008 to June 2010 was completed. We identified 217 patients (249 hips) who were between the ages of 18 to 30 years. The inclusion criteria were (1) insidious-onset hip pain or worsening pain after low-energy sports trauma, (2) positive hip impingement sign, (3) T{\"o}nnis grades 0 to 1, (4) magnetic resonance imaging showing labral tear, and (5) primary hip arthroscopy confirming labral tear. Forty-five patients (52 hips) were excluded for the following reasons: (1) revision hip arthroscopy, (2) high-energy hip trauma, (3) history of surgery involving the femur or pelvis, (4) previous fractures of the femur or pelvis, (5) T{\"o}nnis grades 2 or above, (6) proliferative disease of the hip (i.e., synovial chondromatosis, pigmented villonodular synovitis), (7) neuromuscular disease (i.e., cerebral palsy), and (8) deformities related to Legg-Calv{\'e}-Perthes disease or developmental dysplasia of the hip. Therefore, the cohort study group included 105 (61{\%}) men (123 [62.4{\%}] hips) and 67 (39{\%}) women (74 [37.6{\%}] hips). Sex comparisons were made for the following variables measured on preoperative hip computed tomography scans: alpha angle, acetabular version, femoral version, lateral center-edge angle, and neck-shaft angle. Results: Women had smaller alpha angles (47.8° v 63.6°, P <.001), increased acetabular version (17.3° v 13.9°, P <.001), and increased femoral anteversion (14.4° v 12.1°, P =.05). Conclusions: In young adults with hip pain and labral tears, women have smaller alpha angles and hips that are generally more anteverted. Therefore, in women, cam lesions may be more subtle, preoperative hip version analyses should be encouraged, and rim trimming may need to be cautiously planned to avoid increasing contact stresses at weight-bearing areas after such a procedure. Level of Evidence: Level III, retrospective comparative study.",
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N2 - Purpose: To compare hip morphology between young men and women who presented with hip pain and labral tears. Methods: A retrospective review of our hip arthroscopy registry from March 2008 to June 2010 was completed. We identified 217 patients (249 hips) who were between the ages of 18 to 30 years. The inclusion criteria were (1) insidious-onset hip pain or worsening pain after low-energy sports trauma, (2) positive hip impingement sign, (3) Tönnis grades 0 to 1, (4) magnetic resonance imaging showing labral tear, and (5) primary hip arthroscopy confirming labral tear. Forty-five patients (52 hips) were excluded for the following reasons: (1) revision hip arthroscopy, (2) high-energy hip trauma, (3) history of surgery involving the femur or pelvis, (4) previous fractures of the femur or pelvis, (5) Tönnis grades 2 or above, (6) proliferative disease of the hip (i.e., synovial chondromatosis, pigmented villonodular synovitis), (7) neuromuscular disease (i.e., cerebral palsy), and (8) deformities related to Legg-Calvé-Perthes disease or developmental dysplasia of the hip. Therefore, the cohort study group included 105 (61%) men (123 [62.4%] hips) and 67 (39%) women (74 [37.6%] hips). Sex comparisons were made for the following variables measured on preoperative hip computed tomography scans: alpha angle, acetabular version, femoral version, lateral center-edge angle, and neck-shaft angle. Results: Women had smaller alpha angles (47.8° v 63.6°, P <.001), increased acetabular version (17.3° v 13.9°, P <.001), and increased femoral anteversion (14.4° v 12.1°, P =.05). Conclusions: In young adults with hip pain and labral tears, women have smaller alpha angles and hips that are generally more anteverted. Therefore, in women, cam lesions may be more subtle, preoperative hip version analyses should be encouraged, and rim trimming may need to be cautiously planned to avoid increasing contact stresses at weight-bearing areas after such a procedure. Level of Evidence: Level III, retrospective comparative study.

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