• Corpus ID: 14093665

Osteoarthritis : a consequence of evolution ? FEATURE HIP

@inproceedings{OsteoarthritisA,
  title={Osteoarthritis : a consequence of evolution ? FEATURE HIP},
  author={}
}

• Medicine

2 Osteoarthritis is extremely common and many diff erent causes for it have been described. One such cause is abnormal morphology of the aff ected joint, the hip being a good example of this. For those joints with femo-roacetabular impingement (FAI) or developmental dysplasia of the hip (DDH), a link with subsequent osteo-arthritis seems clear. However, far from being abnormal, these variants may be explained by evolution, certainly so for FAI, and may actually be normal rather than representing deformity or disease. The animal equivalent of FAI is coxa recta, commonly found in species that run and jump. It is rarely found in animals that climb and swim. In contrast are the animals with coxa rotunda, a perfectly spherical femoral head, and more in keeping with the coxa profunda of mankind. This article describes the evolutionary process of the human hip and its link to FAI and DDH. Do we need to worry after all? O steoarthritis (OA) is extraordinarily common and dominates the lives of so many patients and surgeons. Of the many causes suggested for OA, abnormal morphology of a joint is a recurring theme in the literature. The hip is a good example of this with both femoroacetabular impingement (FAI) and developmental dysplasia of the hip (DDH) being widely regarded as predisposing to eventual osteoarthritis. Yet do we really need to worry? Probably yes say some, probably no say others. Could it actually be benefi cial to have one of these morphological variants? Perhaps the answer can be found many millions of years ago. The development of mankind tells us a great deal. Unlike subjects such as particle physics, biology has its grand unifi ed theory – evolution. This is the framework that explains all biological morphology, from protein structure and function to the macro-scopic form of living organisms. 1,2 Journals continue to publish a steady fl ow of inspiring papers on all aspects of evolution. In a recent study of beetles, van de Kamp et al 3 described a previously unknown type of joint. At half a millimetre in size, the hip of the Papuan weevil functions as a nut and bolt 3 (Fig. 1). The common ancestor to such beetles and humans can be dated to approximately 590 million years ago, a time when one of the major splits in evolution occurred, between the deuterostomes (much later giving rise to primates including man) and protostomes …