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Mild acetabular dysplasia and risk of osteoarthritis of the hip: a case–control study
  1. Daniel F McWilliams1,
  2. Sally A Doherty1,
  3. Wendy D Jenkins1,
  4. Rose A Maciewicz2,
  5. Kenneth R Muir3,
  6. Weiya Zhang1,
  7. Michael Doherty1
  1. 1Academic Rheumatology, University of Nottingham, Nottingham, UK
  2. 2AstraZeneca UK, Loughborough, UK
  3. 3Health Sciences Research Institute, University of Warwick, Coventry, UK
  1. Correspondence to Daniel McWilliams, Academic Rheumatology, Clinical Sciences Building, City Hospital, Nottingham NG5 1PB, UK; dan.mcwilliams{at}


Objective To determine whether mild variation in acetabular depth (AD) and shape is a risk factor for osteoarthritis (OA) of the hip.

Methods The unaffected contralateral hip of patients with unilateral hip OA was compared with hips of asymptomatic controls without hip OA, derived from the Nottingham Genetics Osteoarthritis and Lifestyle case–control study. Standardised anteroposterior x-rays of the pelvis were used to measure centre edge (CE) angle and AD. Cut-off points for narrow CE angle and shallow AD were calculated from the control group (mean −1.96×SD). The relative risk of hip OA associated with each feature was estimated using OR and 95% CI and adjusted risks were calculated by logistic regression.

Results In controls, both the CE angle and the AD were lower in the left hip than in the right hip. The CE angle related to age in both hips, and AD of the right hip was lower in men than in women. The contralateral unaffected hip in patients with unilateral hip OA had a decreased CE angle and AD compared with controls, irrespective of side. The lowest tertile of the CE angle in contralateral hips was associated with an eightfold risk of OA (aOR 8.06, 95% CI 4.87 to 13.35) and the lowest tertile of AD was associated with a 2.5-fold risk of OA (aOR 2.53, 95% CI 1.28 to 5.00). Significant increases in the risk of OA were also found as the CE angle and AD decreased.

Conclusion Constitutional mild acetabular dysplasia appears to increase the risk of hip OA.

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  • Competing interests RAM is an employee of AstraZeneca UK, owns stocks for AstraZeneca UK and is named on a patent application for a gene associated with osteoarthritis.

  • Ethics approval This study was conducted with the approval of the Nottingham research ethics committee and all participants gave written informed consent.

  • Funding AstraZeneca UK funded the GOAL study sample and data collection. The Arthritis Research Council provided infrastructure support during the GOAL study (grant 14581).

  • Provenance and peer review Not commissioned; externally peer reviewed.