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In the present study, we used statistical shape modeling (SSM) to evaluate relationships between hip shape and HOA of different severities using UK Biobank DXA images. We performed a cross-sectional study in individuals with left hip dual-energy X-ray absorptiometry (DXA) scans. Statistical shape modeling (SSM) was used to quantify hip shape. Radiographic HOA (rHOA) was classified using osteophyte size and number and joint space narrowing. HOA outcomes ranged in severity from moderate (grade 2) to severe (grade\u2009\u22653) rHOA, hospital-diagnosed HOA, and subsequent total hip replacement (THR). Confounder-adjusted logistic regression between the top 10 hip shape modes (HSMs) and OA outcomes was performed. Further models adjusted for alpha angle (AA) and lateral center-edge angle (LCEA), reflecting acetabular dysplasia and cam morphology, respectively. Composite HSM figures were produced combining HSMs associated with separate OA outcomes. A total of 40,311 individuals were included (mean 63.7\u2009years, 47.8% male), of whom 5.7% had grade 2 rHOA, 1.7% grade\u2009\u22653 rHOA, 1.3% hospital-diagnosed HOA, and 0.6% underwent THR. Composite HSM figures for grade 2 rHOA revealed femoral neck widening, increased acetabular coverage, and enlarged lesser and greater trochanters. In contrast, grade\u2009\u22653 rHOA, hospital-diagnosed HOA, and THR were suggestive of cam morphology and reduced acetabular coverage. Associations between HSMs depicting cam morphology and reduced acetabular coverage and more severe HOA were attenuated by AA and LCEA adjustment, respectively. Relationships between hip shape and HOA differed according to severity. Notably, cam morphology and acetabular dysplasia were features of severe HOA, but unrelated to moderate disease, suggesting possible prognostic utility. \u00a9 2022 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).<\/jats:p>","DOI":"10.1002\/jbmr.4649","type":"journal-article","created":{"date-parts":[[2022,7,10]],"date-time":"2022-07-10T23:19:55Z","timestamp":1657495195000},"page":"1720-1732","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Machine Learning\u2013Derived Acetabular Dysplasia and Cam Morphology Are Features of Severe Hip Osteoarthritis: Findings From UK Biobank"],"prefix":"10.1093","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5729-778X","authenticated-orcid":false,"given":"Monika","family":"Frysz","sequence":"first","affiliation":[{"name":"Medical Research Council Integrative Epidemiology Unit University of Bristol Bristol UK"},{"name":"Musculoskeletal Research Unit University of Bristol Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4102-0190","authenticated-orcid":false,"given":"Benjamin G","family":"Faber","sequence":"additional","affiliation":[{"name":"Medical Research Council Integrative Epidemiology Unit University of Bristol Bristol UK"},{"name":"Musculoskeletal Research Unit University of Bristol Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raja","family":"Ebsim","sequence":"additional","affiliation":[{"name":"Division of Informatics, Imaging and Data Sciences The University of Manchester Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiona R","family":"Saunders","sequence":"additional","affiliation":[{"name":"Centre for Arthritis and Musculoskeletal Health University of Aberdeen Aberdeen UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Lindner","sequence":"additional","affiliation":[{"name":"Division of Informatics, Imaging and Data Sciences The University of Manchester Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6328-4560","authenticated-orcid":false,"given":"Jennifer S","family":"Gregory","sequence":"additional","affiliation":[{"name":"Centre for Arthritis and Musculoskeletal Health University of Aberdeen Aberdeen UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard M","family":"Aspden","sequence":"additional","affiliation":[{"name":"Centre for Arthritis and Musculoskeletal Health University of Aberdeen Aberdeen UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8194-2512","authenticated-orcid":false,"given":"Nicholas C","family":"Harvey","sequence":"additional","affiliation":[{"name":"NIHR Southampton Biomedical Research Centre University of Southampton and University Hospitals Southampton NHS Foundation Trust Southampton UK"},{"name":"Medical Research Council Lifecourse Epidemiology Centre University of Southampton Southampton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Cootes","sequence":"additional","affiliation":[{"name":"Division of Informatics, Imaging and Data Sciences The University of Manchester Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7475-3932","authenticated-orcid":false,"given":"Jon H","family":"Tobias","sequence":"additional","affiliation":[{"name":"Medical Research Council Integrative Epidemiology Unit University of Bristol Bristol UK"},{"name":"Musculoskeletal Research Unit University of Bristol Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,7,10]]},"reference":[{"key":"2024012713580577600_jbmr4649-bib-0001","first-page":"1745","volume":"393","author":"Hunter","year":"2019","journal-title":"Osteoarthritis. 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