The Otto Aufranc Award. On the Etiology of the Cam Deformity: A Cross-sectional Pediatric MRI Study
Autor: | Paul E. Beaulé, Kawan Rakhra, R. Baxter Willis, John Hay, Paul J. Moroz, Leanne M Ward, Hal Dunlap, Sasha Carsen |
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Rok vydání: | 2013 |
Předmět: |
Male
musculoskeletal diseases medicine.medical_specialty Adolescent Sports medicine Cross-sectional study Physical examination Femoracetabular Impingement Disability Evaluation Predictive Value of Tests Risk Factors Activities of Daily Living medicine Humans Orthopedics and Sports Medicine Prospective Studies Range of Motion Articular Child Prospective cohort study Physical Examination Femoroacetabular impingement Symposium: 2013 Hip Society Proceedings Analysis of Variance Chi-Square Distribution medicine.diagnostic_test Femur Neck business.industry Age Factors Acetabulum Femur Head Recovery of Function General Medicine medicine.disease Magnetic Resonance Imaging Biomechanical Phenomena Cross-Sectional Studies Treatment Outcome Orthopedic surgery Etiology Physical therapy Female Hip Joint Surgery business |
Zdroj: | Clinical Orthopaedics and Related Research®. 472:430-436 |
ISSN: | 1528-1132 0009-921X |
Popis: | Femoroacetabular impingement (FAI) has been recognized as a common cause of hip pain as well as a cause of hip arthritis, yet despite this, little is known about the etiology of the cam morphology or possible risk factors associated with its development.The purposes of our study were to determine when the cam morphology associated with FAI developed in a cross-sectional cohort study of pediatric patients pre- and postphyseal closure using MRI and whether increased activity level during the period of physeal closure is associated with an increased likelihood that the cam deformity will develop.Alpha angles were measured at the 3 o'clock (anterior head-neck junction) and 1:30 (anterosuperior head-neck junction) positions in both hips with a cam deformity defined as an alpha angle ≥ 50.5° at the 3 o'clock position. Forty-four volunteers (88 hips) were studied: 23 with open physes (12 females, mean age 9.7 years; 11 males, age 11.7 years) and 21 with closed physes (five females, age 15.2 years; 16 males, age 16.2 years). Daily activity level using the validated Habitual Activity Estimation Scale was compared for patients in whom cam morphology did and did not develop.None of the 23 (0%) patients prephyseal closure had cam morphology, whereas three of 21 (14%, p = 0.02; all males) postclosure had at least one hip with cam morphology. Daily activity level was higher (p = 0.02) for patients with the cam morphology (7.1 hours versus 2.9 hours). Mean alpha angles at the 3 o'clock head-neck position were 38° (95% confidence interval [CI], 37.2°-39.1°) in the open physes group and 42° (95% CI, 40.16°-43.90°) in the closed physes group; at the 1:30 head-neck position, they were 45° (95% CI, 44.0°-46.4°) in the open physes group and 50° (47.9°-52.3°) in the closed physes group.The fact that cam morphology was present exclusively in the closed physeal group strongly supports its development during the period of physeal closure with increased activity level as a possible risk factor. |
Databáze: | OpenAIRE |
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