The Rise and Fall of the Hip: From Skeletal Development to Osteoarthritis

Abstract

Osteoarthritis is a common disease and accounts for a detrimental impact on the quality of life. The etiology of the disease is largely unknown and hence its treatment is limited to pain management until the patient can undergo total joint replacement. In this thesis, we first investigated the role of hip morphology in the development of hip osteoarthritis. It was found that a cam deformity (a non-spherical femoral head due to extra bone formation) is highly associated with development of hip osteoarthritis. We further provided a definition for the presence of a cam deformity. Finally, we investigated if and how a cam deformity develops during skeletal maturation. A cam deformity develops gradually and only during adolescence in between the age of around 13 to 17 years. Its development is a result of high impact sports practice during skeletal growth. In conclusion, in this thesis we found a relatively new risk factor for the development of osteoarthritis (cam deformity). Interestingly, the development of a cam deformity can possibly be prevented during skeletal maturation by adjusting the loads applied to the hip, which might substantially decrease the future prevalence of hip osteoarthritis.