Unveiling the Hidden Links: Anatomical and Radiological Insights into Primary Hip Osteoarthritis

Background: Hip osteoarthritis (HOA) is a disease with globally rising incidence that leads to disability and morbidity, overall, in older populations, and might be primary or secondary to numerous risk factors. The most common idiopathic HOA is generally a diagnosis of exclusion, with pathogenetic mechanisms largely still misunderstood. We aimed to investigate the correlation between femoral–acetabular and spinopelvic anatomical and computed tomography (CT) characteristics, and the presence of primary OA. Methods: We retrospectively analyzed CT scans from 2019 to 2021, excluding patients under 45 years or with conditions affecting the pelvis, sacrum, or lower limbs. Femoral, acetabular, and spinopelvic parameters were measured; signs of OA were analyzed in the hip and knee joints. Patients were categorized into two groups: A (isolated hip OA) and B (no OA); patients with hip OA, also presenting knee OA, were excluded from this study. Results: In total, 232 cases were examined; statistical analyses compared CT parameters between 129 subjects from Group A and 103 patients of Group B. Group A showed a mean femoral version of 16 ± 4.53 degrees, significantly higher than Group B’s 13.16 ± 4.37 degrees (p = 0.0001). Other parameters showed no significant differences. Conclusion: This study highlights an association between femoral version and primary hip OA.