Age-related differences in radiographic parameters for femoroacetabular impingement in hip arthroplasty patients

Arthroscopy. 2013 Jul;29(7):1182-7. doi: 10.1016/j.arthro.2013.04.013.

Abstract

Purpose: To compare the prevalence of femoroacetabular impingement (FAI) radiographic findings between patients aged younger than 50 years and those aged 50 years or older who underwent total hip arthroplasty.

Methods: Total hip arthroplasty patients aged younger than 50 years and those aged 50 years or older were identified retrospectively from a facility medical record database. Fifty patients from each group were randomly selected, and preoperative radiographs were collected. Dysplastic, inflammatory, post-traumatic, and osteonecrosis patients were excluded. Radiographs were evaluated for FAI-specific findings. Intraobserver and interobserver reliability was evaluated with κ statistics for categorical variables and intraclass correlation coefficients for continuous variables. An independent t test was used to compare continuous variables, χ(2) analysis was used for discrete variables, and a z ratio was used to analyze proportions.

Results: The mean age between the subgroups of patients aged younger than 50 years and those aged 50 years or older (43 years and 68 years, respectively) was significantly different (P < .05). Findings in the subgroup aged younger than 50 years included significantly more men (P < .001), decreased lateral joint space with maintained medial joint space (P < .05), significantly greater alpha angle on both the anteroposterior view and the frog-leg lateral view (P < .05), significantly higher Tönnis and Sharp angles (P < .01), and significantly lower center-edge angle (P < .001).

Conclusions: This retrospective case series shows an increased prevalence of FAI findings (specifically cam pathology) in a patient population aged younger than 50 years undergoing total hip arthroplasty when compared with a cohort aged 50 years or older.

Level of evidence: Level III, retrospective comparative study.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Arthroplasty, Replacement, Hip / adverse effects*
  • Female
  • Femoracetabular Impingement / diagnostic imaging*
  • Femoracetabular Impingement / epidemiology
  • Humans
  • Male
  • Middle Aged
  • Observer Variation
  • Prevalence
  • Radiography
  • Reproducibility of Results
  • Retrospective Studies