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Summary Objective Femoroacetabular Impingement (FAI) and Acetabular Dysplasia are common deformities, which have been implicated as a major cause of hip osteoarthritis (OA). We examined whether these subtle deformities of the hip are associated with the development of radiographic OA and total hip replacement (THR) in women. Design A population-based, longitudinal cohort of 1003 women underwent pelvis radiographs at years 2 and 20. Alpha Angle, Triangular Index Height, Lateral Centre Edge (LCE) angle and Extrusion Index were measured. An alpha angle of greater than 65° was defined as Cam-type FAI. Radiographic OA and the presence of a THR were then determined at 20 years. Results Cam-type FAI was significantly associated with the development of radiographic OA. Each degree increase in alpha angle above 65° was associated with an increase in risk of 5% (Odds Ratio (OR) 1.05 [95% confidence interval (CI) 1.01–1.09]) for radiographic OA and 4% (OR 1.04 [95% CI 1.00–1.08]) for THR. For Acetabular Dysplasia, each degree reduction in LCE angle below 28° was associated with an increase in risk of 13.0% (OR 0.87 [95% CI 0.78–0.96]) for radiographic OA and 18% (OR 0.82 [95% CI 0.75–0.89]) for THR. Conclusions This study demonstrates that Cam-type FAI and mild Acetabular Dysplasia are predictive of subsequent OA and THR in a large female population cohort. These are independent of age, BMI and joint space and significantly improve current predictive models of hip OA development.

Patients with simple pubic rami fractures can be divided into two main groups: young people subject to high-energy trauma and elderly people who sustain osteoporotic fractures after minor falls. Cases associated with lifethreatening arterial injury mostly relate to the high-energy group. We report the case of a 70-year-old woman in whom a low-energy fall caused a stable pubic rami fracture injury associated with angiographyproven multiple hemorrhage from branches of both the internal and external iliac arteries which necessitated embolization of the bleeding vessels. As far as we are aware, angiography-proven bleeding from branches of the internal and external iliac arteries in a low-energy, stable pubic rami fracture has not been reported before. This case emphasizes the need for admission and careful hemodynamic monitoring in such cases.