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Femoro-acetabular impingement and its role in the development of osteoarthritis of the hip: A 10-year follow-up study of the Sumiswald cohort

English title Femoro-acetabular impingement and its role in the development of osteoarthritis of the hip: A 10-year follow-up study of the Sumiswald cohort
Applicant Reichenbach Stephan
Number 160153
Funding scheme Project funding (special)
Research institution Institut für Sozial- und Präventivmedizin Universität Bern
Institution of higher education University of Berne - BE
Main discipline Diseases of Bones and Joints
Start/End 01.04.2016 - 30.09.2020
Approved amount 429'000.00
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Keywords (4)

hip impingement; magnetic resonance imaging; Sumiswald cohort study; hip osteoarthritis

Lay Summary (German)

Lead
Die Hüftarthrose ist eine der häufigsten Erkrankungen des Bewegungsapparates und führt zu Schmerzen und Einschränkung der Beweglichkeit. Eine der Ursachen liegt wahrscheinlich in diskreten Formvarianten der Hüftanatomie. Dieses Projekt ist eine 10 Jahres Verlaufsuntersuchung einer Kohorte von jungen Männern.
Lay summary

Die Ursache der Hüftarthrose ist nicht geklärt, eine der möglichen Ursachen sind diskrete Veränderungen der Hüftanatomie, der sogenannten 'Cam-type (Kurbelwelle) Deformität'. Dabei handelt es sich um ein Zuviel an Knochen am Oberschenkelknochen. Bei Hüftbewegungen kommt es zum Anstehen des Knochens an der Hüftpfanne und möglicherweise einer Verletzung des Gelenks.

Wir haben vor 10 Jahren 1080 junge Erwachsene anlässlich der Aushebung des Schweizer Militär in Sumiswald bezüglich der Hüftbeweglichkeit untersucht. Von diesen wurden bei 244 beschwerdefreien jungen Männer eine Magnetresonanztomographie (MRT) der Hüfte durchgeführt. In 25% fanden wir eine 'Cam-type Deformität'.

In dieser Verlaufsuntersuchung werden wir alle Männer wieder kontaktieren und nach ihren Hüftbeschwerden fragen. Die Teilnehmer, welche eine MRT vor 10 Jahren erhalten haben, werden wir wieder zu einer gleichen Untersuchung einladen, um zu schauen, ob und wie sich die Cam-type Deformität verändert hat und ob dadurch ein Schaden am Hüftgelenk entstanden sind.

Dieses Projekt trägt zu unserem Verständnis bei, wie die Hüftarthrose entsteht. Daraus lassen sich Erkenntnisse ableiten, wie das Entstehen der Hüftarthrose verhindert werden kann.

Direct link to Lay Summary Last update: 22.03.2016

Responsible applicant and co-applicants

Employees

Project partner

Collaboration

Group / person Country
Types of collaboration
Schulthess Klinik Zürich Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication

Associated projects

Number Title Start Funding scheme
104778 Femoro-Acetabluar Impingement: Role in Osteoarthritis of the Hip 01.04.2005 NRP 53 Musculoskeletal Health - Chronic Pain
153469 Do high-impact sports in children promote abnormal physeal growth and cam-type deformity of the femoral head during the adolescent growth spurt? - A longitudinal study - 01.03.2015 Project funding (Div. I-III)

Abstract

1.1.BackgroundOsteoarthritis (OA) of the hip is among the primary causes of pain and disability in developed nations. The related treatments and socioeconomic expenditures pose a considerable burden on health and social services. One of the contributing factor may be femoroacetabular impingement (FAI), defined as non-dysplastic deviation of the acetabulum or the proximal femur that could result in hip damage triggered by hip flexion and internal rotation. Ten years ago, we established the Sumiswald inception cohort, consisting of consecutive young males undergoing conscription for the Swiss army. Clinical examination was performed in 1080 participants, and a random sample of 244 subjects underwent hip MRI. We showed that approximately 25% of asymptomatic young men had a cam-type configuration of the hip, a potential risk factor for symptoms and hip damage. 1.2.ObjectivesTo determine (1) whether morphologic characteristics that increase the risk of FAI are associated with a predisposition to the onset of hip pain and OA 10 years after first examination, (2) whether reduced internal rotation at baseline is associated with elevated risk of later hip pain, (3) whether the incidence of morphologic deviations of the hip changes over time, and (4) whether the degree of internal rotation of the hip changes over time.1.3.Methods This is a 10-year follow-up of the inception cohort study (Sumiswald cohort). All original 1080 participants will be mailed a validated self-report questionnaire that focuses on development of hip pain and any surgical procedures performed during the previous 10 years. All participants initially evaluated with MRI will be asked to undergo clinical examination and MRI again. We will use linear and logistic regression models to determine the association between the presence of cam-type deformities of grade = 2 at baseline and pain and structural damage (as detected on MRI) at follow-up. We will use linear and logistic regression models adjusted for age and body mass index to determine the association between internal rotation of <30° at baseline and the WOMAC pain score. Changes in internal rotation and in structural damage of the hip will be evaluated over time with logistic and linear mixed models, and will be expressed as odds ratios. 1.4.Significance of project This research will further our understanding of the mechanisms contributing to OA development in the non-dysplastic hip. The development of OA in individuals with FAI may be prevented or at least delayed by modified professional and sport activities and also possibly by the use of conservative treatments and joint-preserving surgery.
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