Relationship between pelvic incidence and osteoarthritis of the hip

Abstract

ObjectivesSagittal alignment of the lumbosacral spine, and specifically pelvic incidence (PI), has been implicated in the development of spine pathology, but generally ignored with regards to diseases of the hip. We aimed to determine if increased PI is correlated with higher rates of hip osteoarthritis (HOA). The effect of PI on the development of knee osteoarthritis (KOA) was used as a negative control.MethodsWe studied 400 well-preserved cadaveric skeletons ranging from 50 to 79 years of age at death. Each specimen’s OA of the hip and knee were graded using a previously described method. PI was measured from standardised lateral photographs of reconstructed pelvises. Multiple regression analysis was performed to determine the relationship between age and PI with HOA and KOA.ResultsThe mean age was 60.2 years (standard deviation (sd) 8.1), and the mean PI was 46.7° (sd 10.7°). Multiple regression analysis demonstrated a significant correlation between increased PI and HOA (standardised beta = 0.103, p = 0.017). There was no correlation between PI and KOA (standardised beta = 0.003, p = 0.912).ConclusionHigher PI in the younger individual may contribute to the development of HOA in later life.Cite this article: Dr J. J. Gebhart. Relationship between pelvic incidence and osteoarthritis of the hip. Bone Joint Res 2016;5:66–72. DOI: 10.1302/2046-3758.52.2000552.

Acetabular and spino‐pelvic morphologies are different in subjects with symptomatic cam femoro‐acetabular impingement

“…Therefore, radiological assessment of hip pathology should include the review of spino‐pelvic parameters; this could be done either radiographically, or by CT of the entire pelvic ring with multiplanar reconstructions, instead of imaging the hip of interest only. Because of the association between a high PI and an increased risk of hip OA (also shown to be increased with c‐FAI), the relationship between the PI and FAI should be taken into consideration in prospective longitudinal studies looking at factors influencing the formation of cam morphology as well as those at risk of developing symptoms and degenerative changes.…”

“…In line with this, each individual is characterized by his/her pelvic incidence (PI) . It has been postulated that higher PI is associated with increased risk of hip OA …”

Association of early vertebroplasty with risk of hip replacement: a nationwide population-based cohort study

“…However, the deficient coverage of anterior acetabulum applies more pressure on the femoral head, which leads to subchondral insufficiency fracture of the femoral head, necessitating hip replacement. [13][14][15] Patients with TLCF have gait patterns that significantly deviate from normal gait patterns after 6 months of conservative treatment, potentially increasing their risk of falls. [17] Furthermore, a good spinal sagittal alignment reduces the risk of falling, and positive sagittal balance is a radiographic parameter that is most highly correlated with adverse health outcomes.…”

Imaging Methodology for Hip Preservation: Techniques, Parameters, and Thresholds

“…53,74 Recently, Mascarenhas et al 53 showed that increased SPPs are predictive of a hip symptomatic state, and Ng et al 137 corroborated this finding for PI. A significant contribution of these parameters for a symptomatic hip 53,137 and OA 135,136 was suggested. In fact, decreasing values of SS may allow greater impingement-free hip flexion by effectively reducing femoral coverage anteriorly.…”

“…Spinopelvic parameters (SPPs) can be measured using lateral lumbosacral radiographs, 135,136 pelvic CT images, 137 and pelvic MRI. 53,138 Very few studies have addressed differences between measurements on distinct imaging modalities; Moon et al 139 found an increase in SS and a decrease in PT and PI (SS increased by 3.5 degrees, PT decreased by 6.7 degrees, and PI decreased by 3.2 degrees) when comparing XR and CT measurements, which might be associated with positional and methodological changes.…”