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Clin Orthop Relat Res. 2011 Nov;469(11):3229-40. doi: 10.1007/s11999-011-1945-4. Epub 2011 Jul 15.

The cam-type deformity of the proximal femur arises in childhood in response to vigorous sporting activity.

Author information

1
Department of Orthopedic Surgery, University of Bern, Inselspital, CH 3010 Bern, Switzerland. klaus.siebenrock@insel.ch

Abstract

BACKGROUND:

The prevalence of a cam-type deformity in athletes and its association with vigorous sports activities during and after the growth period is unknown.

QUESTIONS/PURPOSES:

We therefore compared the prevalence and occurrence of a cam-type deformity by MRI in athletes during childhood and adolescence with an age-matched control group.

PATIENTS AND METHODS:

We retrospectively reviewed 72 hips in 37 male basketball players with a mean age of 17.6 years (range, 9-25 years) and 76 asymptomatic hips of 38 age-matched volunteers who had not participated in sporting activities at a high level.

RESULTS:

Eleven (15%) of the 72 hips in the athletes were painful and had positive anterior impingement tests on physical examination. Internal rotation of the hip averaged 30.1° (range, 15°-45°) in the control group compared with only 18.9° (range, 0°-45°) in the athletes. The maximum value of the alpha angle throughout the anterosuperior head segment was larger in the athletes (average, 60.5° ± 9°), compared with the control group (47.4° ± 4°). These differences became more pronounced after closure of the capital growth plate. Overall, the athletes had a 10-fold increased likelihood of having an alpha angle greater than 55° at least at one measurement position.

CONCLUSIONS:

Our observations suggest a high intensity of sports activity during adolescence is associated with a substantial increase in the risk of cam-type impingement. These patients also may be at increased risk of subsequent development of secondary coxarthrosis.

LEVEL OF EVIDENCE:

Level II, diagnostic study. See the Guidelines for Authors for a complete description of levels of evidence.

PMID:
21761254
PMCID:
PMC3183218
DOI:
10.1007/s11999-011-1945-4
[Indexed for MEDLINE]
Free PMC Article

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