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The Cam-type Deformity of the Proximal Femur Arises in Childhood in Response to Vigorous Sporting Activity

  • Clinical Research
  • Published:
Clinical Orthopaedics and Related Research®

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.

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Author information

Authors and Affiliations

  1. Department of Orthopedic Surgery, University of Bern, Inselspital, CH, 3010, Bern, Switzerland

    K. A. Siebenrock MD, F. Ferner MD & T. C. Mamisch MD

  2. Joseph Barnhart Department of Orthopedic Surgery, Baylor College of Medicine, Houston, TX, USA

    P. C. Noble MD, PhD

  3. Department of Orthopedic Surgery, University of California, Sharp Memorial Hospital, San Diego, CA, USA

    R. F. Santore MD, PhD

  4. Department of Radiology, Sonnenhof Clinic, Bern, Switzerland

    S. Werlen MD

Authors
  1. K. A. Siebenrock MD
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  2. F. Ferner MD
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  3. P. C. Noble MD, PhD
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  4. R. F. Santore MD, PhD
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  5. S. Werlen MD
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  6. T. C. Mamisch MD
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Corresponding author

Correspondence to K. A. Siebenrock MD.

Additional information

Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

This study was performed at the University of Bern, Switzerland.

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Siebenrock, K.A., Ferner, F., Noble, P.C. et al. The Cam-type Deformity of the Proximal Femur Arises in Childhood in Response to Vigorous Sporting Activity. Clin Orthop Relat Res 469, 3229–3240 (2011). https://doi.org/10.1007/s11999-011-1945-4

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