Etiology of primary osteoarthrititis of the hip

PD Dr. Michael Leunig, Orthopädie, spez. Hüfte, Schulthess Klinik Zürich; PD Dr. med. Peter Jüni, Institut für Sozial- und Präventivmedizin der Universität Bern


Osteoarthritis (OA) of the hip is one of the major causes of pain and disability in the developed world. Resulting therapeutic interventions and socioeconomic expenditures pose a considerable burden on health and social services. Based on experimental and clinical studies, including in situ inspection in a series of 600 consecutive adolescents and young adults undergoing surgical dislocations of the hip, we propose femoro-acetabular impingement (FAI) to cause early OA in the non-dysplastic hip: morphologic deviations of the proximal femur with a decreased anterior head-neck offset (DAHO) may lead to repetitive trauma of the peripheral articular cartilage during flexion and internal rotation, particularly in individuals taking regular exercises. However, the diagnostic accuracy of clinical tests used to screen for DAHO and FAI is uncertain, reliable estimates of the prevalence of DAHO are lacking, and the prognostic relevance of DAHO for the development of early hip pain and OA is unclear.


To determine:
• the prevalence of DAHO in the general population
• the diagnostic accuracy of the clinical test used to screen for DAHO and FAI; and whether DAHO is associated with an increased risk to develop hip pain and early signs of OA.


This project will contribute to our understanding of the mechanisms leading to the development of OA in the non-dysplastic hip. Adaptation of professional and sport activities and, potentially, the use of joint preserving surgery might prevent or at least delay to development of OA in individuals with DAHO.

Project period: 60 months

Budget: CHF 519,448

PD Dr. Michael Leunig
Schulthess Klinik
Lengghalde 2
CH-8008 Zürich

Further applicants:
Prof. Reinhold Ganz, Medical Faculty of the University of Bern, Department of Clinical Research: Orthopaedic Surgery Research Lab, Inselspital Bern
Prof. Willy Hofstetter, Medical Faculty of the University of Bern, Department of Clinical Research
Dr. Peter Jüni, Department of Social and Preventive Medicine, University of Bern
PD Dr. Alex Odermatt, Institut für Molekular- und Systemtoxikologie, Universität Basel