Jeffrey J Nepple1, Jonathan M Vigdorchik2, John C Clohisy3. 1. Department of Orthopaedic Surgery, Washington University School of Medicine, St Louis, Missouri, USA nepplej@wudosis.wustl.edu. 2. Department of Orthopaedic Surgery, New York University-Hospital for Joint Diseases, New York, New York, USA. 3. Department of Orthopaedic Surgery, Washington University School of Medicine, St Louis, Missouri, USA.
Abstract
BACKGROUND: Femoroacetabular impingement (FAI) is recognized as a common cause of hip pain and intra-articular disorders in athletes. Studies have suggested a link between participation in athletics during adolescence and the development of cam-type deformities of the proximal femoral head-neck junction. PURPOSE: To investigate the association of sporting activity participation during adolescence and the development of cam deformity. STUDY DESIGN: Systematic review. METHODS: The PubMed, EMBASE, and Cochrane databases were searched to identify potential studies. Abstracts and manuscripts (when applicable) were independently reviewed by 2 reviewers. Nine studies met the inclusion criteria, including 8 studies that compared the prevalence of cam deformity in athletes with that in controls and 3 studies that compared the prevalence of cam deformity before and after physeal closure (2 with both). A meta-analysis was performed with pooling of data and random-effects modeling to compare rates of cam deformity between athletes and controls. RESULTS: High-level male athletes are 1.9 to 8.0 times more likely to develop a cam deformity than are male controls. The pooled prevalence rate (by hip) of cam deformity in male athletes was 41%, compared with 17% for male controls. The pooled mean alpha angle among male athletes was 61°, compared with 51° for male controls. CONCLUSION: Males participating in specific high-level impact sports (hockey, basketball, and possibly soccer) are at an increased risk of physeal abnormalities of the anterosuperior head-neck junction that result in a cam deformity at skeletal maturity.
BACKGROUND: Femoroacetabular impingement (FAI) is recognized as a common cause of hip pain and intra-articular disorders in athletes. Studies have suggested a link between participation in athletics during adolescence and the development of cam-type deformities of the proximal femoral head-neck junction. PURPOSE: To investigate the association of sporting activity participation during adolescence and the development of camdeformity. STUDY DESIGN: Systematic review. METHODS: The PubMed, EMBASE, and Cochrane databases were searched to identify potential studies. Abstracts and manuscripts (when applicable) were independently reviewed by 2 reviewers. Nine studies met the inclusion criteria, including 8 studies that compared the prevalence of camdeformity in athletes with that in controls and 3 studies that compared the prevalence of camdeformity before and after physeal closure (2 with both). A meta-analysis was performed with pooling of data and random-effects modeling to compare rates of camdeformity between athletes and controls. RESULTS: High-level male athletes are 1.9 to 8.0 times more likely to develop a camdeformity than are male controls. The pooled prevalence rate (by hip) of camdeformity in male athletes was 41%, compared with 17% for male controls. The pooled mean alpha angle among male athletes was 61°, compared with 51° for male controls. CONCLUSION: Males participating in specific high-level impact sports (hockey, basketball, and possibly soccer) are at an increased risk of physeal abnormalities of the anterosuperior head-neck junction that result in a camdeformity at skeletal maturity.
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