CORR Insights(®): The 2015 Frank Stinchfield Award: Radiographic Abnormalities Common in Senior Athletes With Well-functioning Hips but Not Associated With Osteoarthritis.

Abstract

T he current understanding of the etiology of hip osteoarthritis (OA) is that certain variations in hip anatomy predispose the joint to the development of OA [7]. Natural history studies have shown that hips with dysplasia and femoroacetabular impingement (FAI) are more likely to develop arthritis [1, 17]. When analyzing the etiology of idiopathic OA, up to 79% of hips can be attributed to underlying hip deformity, with dysplasia implicated in 39% to 49% and CAM deformity in 40% to 63% [4, 8, 16]. During the past 30 years, the innovation and adoption of surgical techniques such as periacetabular osteotomy (PAO) [6] and hip arthroscopy have allowed surgeons to alter the mechanical environment of the hip at risk forOAwith the goal of decreasing the likelihood that arthritis will develop. There is some evidence that these interventions can delay or even prevent OA [12, 15]. Consequently, the biggest challenge for surgeons is to identify the hip at mechanical risk for degeneration and to accurately correct the anatomical cause of the mechanical dysfunction. However, dysplastic and FAI anatomy are spectra of deformity that are modulated by many nonanatomical factors such as genetics, activity level, and age, making it difficult to predict which hips with dysplasia or FAI will eventually become symptomatic and develop OA. Previous estimates of radiographic prevalence in the general population range from 3% to 13% for dysplasia [9, 10] and 15% to 25% for FAI [8, 14] Although prior studies demonstrated that a large portion of arthritic hips had underlying dysplasia or FAI, it remains unknown how many hips with radiographic signs of dysplasia or FAI stay asymptomatic and continue to function into old age. In the current study, Anderson and colleagues reported the prevalence of hip dysplasia and FAI morphology in a group of highly functional senior athletes. Although other studies have This CORR Insights is a commentary on the article ‘‘The 2015 Frank Stinchfield Award: Radiographic Abnormalities Common in Senior Athletes With Well-functioning Hips but Not Associated With Osteoarthritis’’ by Anderson and colleagues available at: DOI: 10.1007/s11999-015-4379-6. The author certifies that he, or any member of his immediate family, has no funding or commercial associations (eg, consultancies, stock ownership, equity interest, patent/ licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request. The opinions expressed are those of the writers, and do not reflect the opinion or policy of CORR or The Association of Bone and Joint Surgeons. This CORR Insights comment refers to the article available at DOI: 10.1007/s11999-0154379-6. S. Y. Pun MD (&) Department of Orthopaedic Surgery, Stanford University, 300 Pasteur Drive, Edwards R105, Stanford, CA 94305, USA e-mail: sypun@stanford.edu CORR Insights Published online: 16 July 2015 The Association of Bone and Joint Surgeons1 2015