Nature or Nurture?

[Tin Soldier]

So my brother mentions to me a month ago that he's having leg pain, stiffness, difficulty with ROM,...  so I suggested sending his images off to a few of the Docs.  So he's doing that.  I can tell with my notsoexpert eyes that there is definitely narrowing in the spacing at the acetabular rim.  I suspect he may be looking at new hips in the not distant future.

So the question - is it nature or nurture (actually the opposite of nuture - beat the crap out your hips when you're young), or maybe both?  or maybe purely coincidence, don't think so.

I have heard of a study or two on this subject but never found anything. 

My brother is one year older than I and we both skied about every weekend from age 12 to 18 at Mt. Hood OR (wet Cascade cement and longer seasons than most ski areas).  He was never as aggressive as I and I played a lot of soccer and ran cross-country, which he didn't.  Maybe our hips are exactly the same and it just took a little longer for OA to catch up to him.  Crazy huh? 

Any one have any thoughts or know of any papers on this subject?

[Lauren Lee]

Well, my mom has OA in her hips and knees  and I do not. Her mother had it. My younger sisters have it but my younger brothers do not. Well...I did ...but the cause of mine was a nasty snowmobile accident 30 years ago. And then years of trying to do things like I didn't have a hip injury. My other hip is fine. My knees are good. So in my case...it is nurture ...I am 59 years old.
My doc explained that back in the day athletes (and non-athletes) would have labral tears, which is what I had. The doc back then called it a "groin pull...like football players get". There was no treatment other than PT. That labram tears and opens your hip joint up to all kinds of unfortunate conditions.
so...I guess it could be nature...or nurture. That's all I've got.

[hernanu]

Hey Tin!

I think it's a little of both.

From the NIH (National Institute of Health - US) :

Other factors can also lead to OA.

• OA tends to run in families.
• Being overweight increases the risk of OA in the hip, knee, ankle, and foot joints because extra weight causes more wear and tear.
• Fractures or other joint injuries can lead to OA later in life. This includes injuries to the cartilage and ligaments in your joints.
• Jobs that involve kneeling or squatting for more than an hour a day put you at the highest risk. Jobs that involve lifting, climbing stairs, or walking also put you at risk.
• Playing sports that involve direct impact on the joint (such as football), twisting (such as basketball or soccer), or throwing also increase the risk of arthritis.

Reference: http://www.nlm.nih.gov/medlineplus/ency/article/000423.htm

I looked at this list and chuckle mightily from my three year HR perch... 

I've had every single one of these, except the family thing. I checked with my forebears and none of them remember anyone having this; who knows if someone had it and just didn't recognize it.

I also have a theory (  ) that if you're physically active, and someone like (within your family) you is not, then any inherited predilection is likely to be confronting you long before them. If they never get off the couch, maybe never.

I played all the above and more sports at a good level. Had plenty of injuries, and put myself through grad school working construction (mostly floors), then renovated two of my houses.

As to the weight gain, I can track that to the onset of OA. The diminution of my flexibility, pain, etc. I think contributed heavily to that. I think the doctors see the weight that their patients are at, and give that weight ( ) without digging deeper (and further back in time) and seeing the influence of OA.

Not to say that it doesn't contribute, but it's just a small observation.

So - nurture and nature I think are part and parcel of OA, like in many other things.

[Tin Soldier]

Yeah I had the labral tear in both hips and it seemed the OA increased significantly after that. 

Thanks for ref Hern.  I agree part and parcel.  My Dad does not have these issues, but he did a lot more reading than my brother and I.  My Mom did not have any of these issues, so it bet it really is a combo of nature and nurture. 

It is interesting to think of the perspective now after a couple years of having HR.  Such a world of difference. 

[Jason0411]

My brother had his HR at aged 35 I managed to get to 45. I had severe Perthes as a child in both hips and both got OA. Nick as it was discovered when his hip started playing up in his 30's had had mild Perthes in his left hip and it went undetected. When I was little my surgeon told my parents that if I didn't have the Osteotomies then I would be crippled with Oa by the time I was 30. I had the sugery and got to 45 Nick didn't and got to 35. Coincidence?

[Arrojo]

In my case, both.  One of the orthopedists I saw (not Dr. Su) commented that the physical structure of my hip partly was at fault.  In other words, blame my parents.

But then, I totally beat on it, running marathons, sprinting, hockey, all kinds of stuff through all kinds of pain, so it is my fault as well.