Gender differences in acetabular morphology in patients with end-stage osteoarthritis.

Abstract

BACKGROUND: Hip osteoarthritis is one of the leading causes of global disability and contributes significant and widespread physical, psychological and socioeconomic burden amongst patients. There has been increasing evidence that acetabular morphological differences between individuals, and specifically genders, may be a major contributor to the development and severity of hip osteoarthritis. METHODS: These morphological differences between genders are well documented amongst asymptomatic hips, but little research has been conducted in patients with hip osteoarthritis. This study aimed to analyze the parameters of acetabular inclination and acetabular anteversion in patients undergoing total hip arthroplasty and determine whether there are gender specific differences. CT scans of 369 patients were analyzed using standard radiological software. RESULTS: The mean acetabular inclination measures for females and males was 42.9° ± 5.2° and 42.1° ± 5.0° respectively (P = 0.111). In females, the mean acetabular anteversion at 10mm, 20mm, and 30mm below the superior rim of the acetabulum was measured as 15.3° ± 10.0°, 21.1° ± 7.9°, and 23.1° ± 8.0° respectively. In males, the mean acetabular anteversion at 10mm, 20mm, and 30mm below the superior rim of the acetabulum was measured as 12.3° ± 9.4°, 17.2° ± 7.5°, and 17.8° ± 7.4° respectively. At all three transverse levels, superiorly to inferiorly, acetabular version was found to be significantly higher in females than males (P = 0.003, P <0.001, and P<0.001 respectively.) CONCLUSION: These findings may provide insight into the morphological drivers of osteoarthritis and how these differ between genders. This enables the capacity for research into join preserving techniques in younger symptomatic adults, delaying or preventing the need for interventions such as total hip arthroplasty. Gender differences identified in this study also provide scope for current and future techniques to be tailored to each gender, resulting in optimal clinical outcomes.