Objective. Cam deformity and acetabular dysplasia have been recognized as relevant risk factors for hip osteoarthritis (OA) in a few prospective studies with limited sample sizes. To date, however, no evidence is available from prospective studies regarding whether the magnitude of these associations differs according to sex, body mass index (BMI), and age.Methods. Participants in the Rotterdam Study cohort including men and women ages 55 years or older without OA at baseline (n 5 4,438) and a mean follow-up of 9.2 years were included in the study. Incident radiographic OA was defined as a Kellgren/Lawrence grade of ‡2 or a total hip replacement at follow-up. Alpha and center-edge angles were measured to determine the presence of cam deformity and acetabular dysplasia/pincer deformity, respectively. Odds ratios (ORs) were calculated to assess the associations between both deformities and the development of OA.Results. Subjects with cam deformity (OR 2.11, 95% confidence interval [95% CI] 1.55-2.87) and those with acetabular dysplasia (OR 2.19, 95% CI 1.50-3.21) had a 2-fold increased risk of developing OA compared with subjects without deformity, while pincer deformity did not increase the risk of OA. Stratification analyses showed that the associations of cam deformity and acetabular dysplasia with OA were driven by younger individuals, whereas BMI did not influence the associations. Female sex appears to modify the risk of hip OA related to acetabular dysplasia.Conclusion. Individuals with cam deformity and those with acetabular dysplasia are predisposed to OA; these associations were independent of other well-known risk factors. Interestingly, both deformities predisposed to OA only in relatively young individuals. Therefore, early identification of these conditions is important.Osteoarthritis (OA) of the hip is one of the main causes of musculoskeletal disability with pain and dysfunction in the elderly (1). Epidemiologic studies have identified several risk factors predisposing to hip OA, including increasing age, male sex (after age 55 years, hip OA is more common in women), excess body weight (which has a stronger association with knee OA), trauma, mechanical workload (occupational) and leisure-time physical activity, and gross bony abnormalities (i.e., congenital hip dislocation, Legg-Calve-Perthes disease, or slipped capital femoral epiphysis) (1-3). Moreover, a review study (4) showed an association between bony abnormalities (e.g., acetabular dysplasia and cam deformity) and hip OA, although the conclusions drawn were based on limited prospective evidence (based on 110 individuals in 1 study of cam deformity, and a total of 1,365 individuals in 5 studies of dysplasia) (5-10).Recent prospective epidemiologic studies have supported the notion that mild acetabular dysplasia is associated with an increased risk of incident hip OA
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