The Rise of Structural Osteoarthritis of the Hip: Commentary on an article by William Z. Morris, MD, et al.: "Capital Femoral Growth Plate Extension Predicts Cam Morphology in a Longitudinal Radiographic Study".

Abstract

By the creative use of 80-year-old serial radiographs from the longitudinal Brush growth study in Cleveland, Ohio, Morris et al. have made an important contribution to our understanding of the evolution of proximal femoral cam morphology. One obvious potential limitation is the extrapolation of data from the 1940s to the present growth patterns of the proximal femoral physeal plate in adolescents, given improved nutrition, changing activity levels, and other unknown factors. However, the study participants were presumably children of parents with the financial capacity to have them monitored regularly by a pediatrician, and they participated in “health contests,” thereby permitting us to presume that they were comparable with today’s adolescents. Over fifty years ago, Murray1 described the “tilt deformity” of the femoral head and neck as a precursor of osteoarthritis of the hip. Numerous other studies have supported the theory that a substantial proportion of noninflammatory osteoarthritis is secondary to anatomical variations in hip development2. It is now 15 years since Ganz et al.3,4 linked …