The Hip and Scoliosis Connection in Teens

Patients with adolescent idiopathic scoliosis (AIS) have a higher rate of hip dysplasia and recurrent dislocation than other teens, according to a new study.

The study, “The Prevalence of Hip Pathologies in Adolescent Idiopathic Scoliosis,” was published online in the May-June 2022 issue of The Journal of Orthopaedics.

“Adolescent idiopathic scoliosis is the most common form of abnormal spine curvature observed in patients aged 10 to 18. Typically characterized by shoulder height and waistline asymmetry, adolescent idiopathic scoliosis may drive uneven distribution of force in the hips, leading to increased rates of concurrent hip diagnoses,” the researchers wrote.

In this retrospective review, the research team used data from Healthcare Cost and Utilization Project’s Nationwide Inpatient Sample to compare the differences in rates and clusters of hip diagnoses with patients with adolescent idiopathic scoliosis and those without it.

Overall, there with 24,656 patients with AIS and 24,656 patients without AIS that were included in the analysis. The adolescent idiopathic scoliosis group was more female than male (66% vs. 59%) and had lower rates of obesity.

Out of both groups, about 1.1% of the patients had at least one hip diagnosis: congenital deformity (0.31%), development dysplasia (0.24%), recurrent dislocation (0.18%), isolated dislocation (0.09%), osteonecrosis (0.08%), osteochondrosis (0.07%), acquired deformity (0.03%) and osteoarthritis (0.02%).

The adolescent idiopathic scoliosis patients had lower rates of osteonecrosis, but higher rates of all other hip diagnoses, including dysplasia (0.41% vs. 0.07%, p < 0.001), recurrent dislocation (0.32% vs. 0.03%, p < 0.001), isolated dislocation (0.13% vs. 0.06%, p < 0.001), and osteoarthritis (0.04% vs. 0.01%, p = 0.084).

Having more than one hip diagnoses was rare in both groups, with only 0.03% of all the patients having multiple hip diagnoses.

“Compared to unaffected patients of similar ages, patients with adolescent idiopathic scoliosis had higher overall rates of hip diagnoses, including dysplasia and recurrent dislocation. A higher trend of precocious osteoarthritis was also observed at a higher rate in adolescent idiopathic scoliosis patients, although this difference was not statistically significant,” the study authors wrote.

“Our results present an argument for surgical realignment in the coronal and sagittal planes to neutralize asymmetrical forces in the hips and suggest the need for increased awareness and clinical screening for hip-related disorders in adolescent idiopathic scoliosis patients.”

Study authors included Cole Bortz, Tyler K. Williamson, Sara Naessig, Bailey Imbo, Lara Passfall, Oscar Krol, Peter Tretiakov, Rachel Joujon-Roche, Kevin Moattari, Salman Ahmad, Vivek Singh, Stephane Owusu-Sarpong, Shaleen Vira, and Peter G. Passias, all of NYU Langone Orthopedic Hospital.

Ammar Adenwalla, Navraj Sagoo, Shaleen Vira, all of the University of Texas Southwestern Medical Center and Basse Diebo of SUNY Downstate also contributed to the study.