Do changes in femoral neck geometry predict hip osteoarthritis?

A wider femoral neck and more medial centroid position of bone mineral in the femoral neck are associated with an increased risk of prevalent, incident, and progressive radiographic hip osteoarthritis (RHOA). These differences are detectable early in the natural history of hip OA.

Javaid and associates studied 9704 white women 65 years or older in the Study of Osteoporotic Fractures. Common RHOA phenotypes were defined as composite (osteophytes and joint-space narrowing [JSN]), atrophic (JSN, no osteophytes), or osteophytic (femoral osteophytes, no JSN). Pelvic x-ray films were taken at baseline and 8 years later, and hip dual-energy x-ray absorptiometry (DEXA) scans were taken. The Hip Structure Analysis program was applied to the DEXA images to determine bone mineral density and geometry, as well as bone mass, at 3 coronal locations.

Women with a wide femoral neck positioned medially and centroid tended to have osteophytic and composite phenotypes of RHOA but not the atrophic phenotype. Those who had a wide femoral neck positioned centroid also tended to have progression of osteophytes.

The authors noted that qualitative differences in bone remodeling may be critical in the development of specific OA phenotypes and may help identify hips that are at greatest risk for structural progression.