Inflammatory response of articular cartilage to femoroacetabular impingement in the hip

Review written by Dr Joanne Kemp info

Key Points

  1. People with femoroacetabular impingement (FAI) syndrome +/- advanced hip osteoarthritis have poor cartilage quality and higher levels of inflammation at the femoral-head neck junction than people with hip dysplasia or healthy controls.
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BACKGROUND & OBJECTIVE

Hip osteoarthritis (OA) is a problem that affects one in five people in middle age, and up to 40% of people in older age. Hip joint morphology, including the bone shapes seen in femoroacetabular impingement (FAI) syndrome and hip dysplasia, are thought to be associated with the development of osteoarthritis in many cases. Inflammation is thought to be an important contributor to the development and progression of osteoarthritis (1,2). However, little is known about the role of inflammation in FAI syndrome, when osteoarthritis might be in its infancy.

Therefore, the aim of this paper was to evaluate the levels and microscopic patterns of inflammatory markers in cartilage located at the head-neck junction of the femur in patients with cam-type FAI syndrome. The authors hypothesized that articular cartilage from the impingement zone of patients with FAI syndrome will have high levels of inflammation and that this would reflect the initial inflammatory process in the development of hip osteoarthritis.

Hip osteoarthritis affects up to 40% of people in older age.
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Targeted interventions that optimize movement patterns and muscle function around the hip joint, thus optimizing loads in the “impingement zone” of the hip, could prove to be equally as effective as surgery.

METHODS

The researchers took cartilage samples from the femoral head-neck junction (thought to be the “impingement zone” in FAI syndrome) from 45 patients during hip arthroscopy or hip replacement surgery. Cartilage samples were taken from 15 patients with cam-type FAI syndrome,

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