Abstract
The cam deformity may cause impingement and probably leads to osteoarthritis of the hip. The aetiology of the cam deformity is incompletely understood. Vigorous training during skeletal growth can lead to the development of cam and symptoms of femoro-acetabular impingement and subsequent osteoarthritis of the hip. The purpose of this study was to compare the radiographic characteristics and range of motion between a group of athletes and a non-athletic control group. Thirty-two male athletes (17 soccer players and 15 ice-hockey players) and thirty non-athletes, used as a control group, were examined clinically and radiographically. Hip range of motion was measured and the FADIR and FABER tests were performed. Standard radiographs of both hips were taken. The centre-edge angle, alpha angle, caput-collum-diaphysis angle, head-neck offset and Tönnis grade were registered. The athletes had a higher Tönnis grade (right P = 0.009, left P = 0.004), more pain on the FADIR test (right P = 0.006, left P = 0.001) and lower ROM in internal (right P = 0.003, left P = 0.025) and external rotation (P < 0.001). A superiorly placed cam deformity (seen on an AP pelvis view) was correlated with reduced external rotation (right P = 0.001, left P = 0.004) and mild osteoarthritis (Tönnis grade 1), (P = 0.015, left P = 0.020), while a more anteriorly placed cam deformity (seen on a modified Lauenstein view) was correlated with reduced internal rotation (right P = 0.029, left P = 0.013). A lower range of motion, more osteoarthritic changes and more pain were found in the athletes than the controls. The control group had more cam deformities than previously reported.
Highlights
In addition to hip and groin pain, reduced range of motion (ROM) is frequently reported in patients with femoroacetabular impingement (FAI)
The main finding in the present study is that, there were no differences in the radiographic criteria used to quantify either the cam or the pincer deformity, the athletes had a lower range of motion compared with the controls
The external rotation appears to be more affected in individuals where the cam deformity is located superiorly on the head neck junction, while the internal rotation is more affected if the deformity is located more anteriorly
Summary
In addition to hip and groin pain, reduced range of motion (ROM) is frequently reported in patients with femoroacetabular impingement (FAI). Previous studies have reported that patients with FAI have reduced hip flexion and internal rotation on clinical examination [1, 2]. Several studies have reported that FAI is a common cause of hip and groin pain, reduced ROM and impaired performance in the athlete [3]. Evidence has emerged, supporting mechanical factors affecting the proximal femoral physis, as a cause of cam deformity. The cam deformity has been shown to emerge from the physeal scar of the proximal femoral physis [3] and to develop during adolescence in response to vigorous sporting activity [14,15,16]. In a biomechanical study of young porcine hips, microfractures in the epiphyseal plate and
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