Igor Tak1, Adam Weir2, Rob Langhout3, Jan Hendrik Waarsing4, Janine Stubbe5, Gino Kerkhoffs6, Rintje Agricola4. 1. Sports Rehabilitation and Manual Therapy Department, Physiotherapy Utrecht Oost, Utrecht, The Netherlands Department of Orthopaedics and Sports Traumatology, Academic Medical Centre Amsterdam, Amsterdam, The Netherlands. 2. Sports Medicine Department, Sports Groin Pain Centre, Aspetar Hospital, Doha, Qatar. 3. Private Practice Physiotherapy Dukenburg, Nijmegen, The Netherlands. 4. Department of Orthopaedics, Erasmus University Medical Centre, Rotterdam, The Netherlands. 5. Amsterdam University of Applied Sciences, School of Sports & Nutrition, Amsterdam, The Netherlands. Codarts University for the Arts, Rotterdam, The Netherlands. 6. Department of Orthopaedics and Sports Traumatology, Academic Medical Centre Amsterdam, Amsterdam, The Netherlands.
Abstract
BACKGROUND/AIM: Cam deformity (CD) is likely a bony adaptation in response to high-impact sports practice during skeletal growth. We ascertained whether a dose-response relationship exists between the frequency of football practice during skeletal growth and the presence of a CD in adulthood, and if the age at which a football player starts playing football is associated with the presence of a CD in adulthood. METHODS: Prevalence of a CD (α angle>60°) and a pathological CD (α angle>78°) was studied using standardised anteroposterior (AP) and frog-leg lateral (FLL) radiographs that were obtained during seasonal screening. The age of starting to play football with a low frequency (LF; ≤3 times/week) and high frequency (HF; ≥4 times/week) was retrospectively assessed. The differences in prevalence of a CD per hip, in either view, between groups were calculated by logistic regression with generalised estimating equations. RESULTS: 63 players (mean(±SD) age 23.1(±4.2) years) participated, yielding 126 hips for analysis. The prevalence of a CD in the FLL was 40% (n=82) in players who started playing HF football from the age of 12 years or above, and 64% (n=44) in those playing HF football before the age of 12 years (p=0.042). This was also true for a pathological CD (12% vs 30%, p=0.038). The AP views revealed no difference. CONCLUSIONS: Our results indicate a probable dose-response relationship between the frequency of football practice during skeletal growth and the development of a CD, which should be confirmed in future prospective studies. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
BACKGROUND/AIM: Camdeformity (CD) is likely a bony adaptation in response to high-impact sports practice during skeletal growth. We ascertained whether a dose-response relationship exists between the frequency of football practice during skeletal growth and the presence of a CD in adulthood, and if the age at which a football player starts playing football is associated with the presence of a CD in adulthood. METHODS: Prevalence of a CD (α angle>60°) and a pathological CD (α angle>78°) was studied using standardised anteroposterior (AP) and frog-leg lateral (FLL) radiographs that were obtained during seasonal screening. The age of starting to play football with a low frequency (LF; ≤3 times/week) and high frequency (HF; ≥4 times/week) was retrospectively assessed. The differences in prevalence of a CD per hip, in either view, between groups were calculated by logistic regression with generalised estimating equations. RESULTS: 63 players (mean(±SD) age 23.1(±4.2) years) participated, yielding 126 hips for analysis. The prevalence of a CD in the FLL was 40% (n=82) in players who started playing HF football from the age of 12 years or above, and 64% (n=44) in those playing HF football before the age of 12 years (p=0.042). This was also true for a pathological CD (12% vs 30%, p=0.038). The AP views revealed no difference. CONCLUSIONS: Our results indicate a probable dose-response relationship between the frequency of football practice during skeletal growth and the development of a CD, which should be confirmed in future prospective studies. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
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