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Statistical shape modeling of the hip and the association with hip osteoarthritis: a systematic review


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van Buuren, MMA, Arden, NK, Bierma-Zeinstra, SMA, Bramer, WM, Casartelli, NC, Felson, DT, Jones, G ORCID: 0000-0002-9814-0006, Lane, NE, Lindner, C, Maffiuletti, NA, van Meurs, JBJ, Nelson, AE, Nevitt, MC, Valenzuela, PL, Verhaar, JAN, Weinans, H and Agricola, R 2021 , 'Statistical shape modeling of the hip and the association with hip osteoarthritis: a systematic review' , Osteoarthritis and Cartilage, vol. 29, no. 5 , pp. 607-618 , doi: 10.1016/j.joca.2020.12.003.

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Objective: To summarize available evidence on the association between hip shape as quantified by statistical shape modeling (SSM) and the incidence or progression of hip osteoarthritis.Design: We conducted a systematic search of five electronic databases, based on a registered protocol (available: PROSPERO CRD42020145411). Articles presenting original data on the longitudinal relationship between radiographic hip shape (quantified by SSM) and hip OA were eligible. Quantitative meta-analysis was precluded because of the use of different SSM models across studies. We used the Newcastle-Ottawa Scale (NOS) for risk of bias assessment.Results: Nine studies (6,483 hips analyzed with SSM) were included in this review. The SSM models used to describe hip shape ranged from 16 points on the femoral head to 85 points on the proximal femur and hemipelvis. Multiple hip shape features and combinations thereof were associated with incident or progressive hip OA. Shape variants that seemed to be consistently associated with hip OA across studies were acetabular dysplasia, cam morphology, and deviations in acetabular version (either excessive anteversion or retroversion).Conclusions: Various radiographic, SSM-defined hip shape features are associated with hip OA. Some hip shape features only seem to increase the risk for hip OA when combined together. The heterogeneity of the used SSM models across studies precludes the estimation of pooled effect sizes. Further studies using the same SSM model and definition of hip OA are needed to allow for the comparison of outcomes across studies, and to validate the found associations.

Item Type: Article
Authors/Creators:van Buuren, MMA and Arden, NK and Bierma-Zeinstra, SMA and Bramer, WM and Casartelli, NC and Felson, DT and Jones, G and Lane, NE and Lindner, C and Maffiuletti, NA and van Meurs, JBJ and Nelson, AE and Nevitt, MC and Valenzuela, PL and Verhaar, JAN and Weinans, H and Agricola, R
Keywords: anatomy, coxa valga, coxa vara, epidemiology, femoroacetabular impingement, pincer
Journal or Publication Title: Osteoarthritis and Cartilage
Publisher: W.B. Saunders For The Osteoarthritis Research Society
ISSN: 1063-4584
DOI / ID Number: 10.1016/j.joca.2020.12.003
Copyright Information:

© 2020 The Authors. Published by Elsevier Ltd on behalf of Osteoarthritis Research Society International. This is an open access article under the Creative Commons Attribution 4.0 International (CC BY 4.0 license (

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