Tönnis grading of hip osteoarthritis

vigente

Grades hip osteoarthritis radiographically.

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Escala de categorias

0 1 2 3

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Procedência e vigência

Órgão emissor: Orthopedic consensus
Versão: 1976
Ano: 1976
Família: léxico
Tipo de lógica: flat
Modalidade: XR
Fonte primária: Normal values of the hip joint for the evaluation of X-rays (Tönnis)
Última verificação: 2026-06-26
Última checagem: 2026-06-26

Lógica de decisão

Forma estruturada (flat). Uma futura calculadora a lê; as categorias abaixo são a superfície legível.

Mostrar a lógica estruturada (JSON)

{
  "categories": [
    "0",
    "1",
    "2",
    "3"
  ]
}

Categorias num relance

Cat.	Significado	Conduta	Risco	Fonte
0	Grade 0 No radiographic signs of osteoarthritis: no subchondral sclerosis, normal joint space, no subchondral cysts, and a normally spherical femoral head.	Favorable for joint-preserving surgery: the literature supports hip preservation (arthroscopy/FAI correction, osteotomy) for Tonnis 0-1 hips, with the most predictable outcomes.	Best prognosis for hip preservation; lowest reported conversion to total hip arthroplasty after arthroscopy.	okfonte Tonnis grade definitions from open-access PMC7391593 (binary Tonnis modification), Table 1 (grade 0 = no OA); preservation-for-0/1 principle from the same article ('hip preservation for hips graded Tonnis 0 and 1, replacement for 2 and 3').
1	Grade 1 Mild osteoarthritis: increased subchondral sclerosis with minimal joint-space narrowing and early osteophyte formation; the femoral head contour remains essentially normal.	Still suitable for joint-preserving surgery: arthroscopy/FAI surgery in selected patients shows durable improvement, though slightly less reliable than grade 0.	Good prognosis: outcomes after hip preservation are generally predictable in Tonnis 0-1.	okfonte Tonnis grade definitions from open-access PMC7391593, Table 1 (grade 1 = sclerosis, minimal JSN, osteophytes); preservation suitability for Tonnis 0-1 from the same article.
2	Grade 2 Moderate osteoarthritis: small subchondral cyst formation with moderate joint-space narrowing and moderate loss of femoral-head sphericity.	Gray zone: joint preservation/arthroscopy has only a limited, selective role with clinical equipoise; many favor caution because conversion to arthroplasty is markedly more likely.	Worse prognosis than grade 1: Tonnis 2 at baseline carries a significantly higher risk of conversion to total hip arthroplasty (about 3.4-fold relative to Tonnis 1), with 10-year arthroscopy survivorship ~38% vs ~81% for grade 1.	okfonte Grade-2 definition from open-access PMC7391593, Table 1 (small cysts, moderate JSN); THA conversion RR 3.44 (95% CI 1.81-6.55) and 10-yr survivorship 38% vs 81% from open-access PMC12205409 (Nikou et al., 10-year hip-arthroscopy outcomes).
3	Grade 3 Severe (advanced) osteoarthritis: large subchondral cysts, severe joint-space narrowing or obliteration, and severe deformation of the femoral head.	Total hip arthroplasty is the realistic treatment: hip-preservation/arthroscopy is generally not recommended at this stage of advanced degeneration.	Poorest prognosis for preservation: hip-preserving procedures are rarely durable, and arthroplasty is the reliable option.	okfonte Grade-3 definition from open-access PMC7391593, Table 1 (large cysts, joint-space obliteration, severe head deformation); replacement-rather-than-preservation for Tonnis 2-3 stated in the same article.

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