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
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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