The Otto Aufranc Award. On the Etiology of the Cam Deformity: A Cross-sectional Pediatric MRI Study

Carsen, Sasha; Moroz, Paul J.; Rakhra, Kawan; Ward, Leanne M.; Dunlap, H.; Hay, John; Willis, R. Baxter; Beaulé, Paul E.

doi:10.1007/s11999-013-2990-y

Cited by 81 publications

(79 citation statements)

References 31 publications

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“…These results are comparable with previous reports on asymptomatic adolescents and adults. [4][5][6][7][8][9][24][25][26][27] We noted a higher prevalence of cam morphology than Monazzam et al 7 and Schmitz et al 8 This may be secondary to the use of different measurement techniques for the a-angle. We measured the a-angle on radial reformatted images.…”

Section: Discussionmentioning

confidence: 58%

“…None of the subjects in their prephyseal closure group had elevated a-angles on MRI, whereas 14% of their closed physeal group had elevated a-angles and all were male. 9 Our study is the largest published series to date on the prevalence of FAI morphology in asymptomatic adolescents. We found a 16.8% overall prevalence of cam-type FAI morphology and this was nearly 3 times more common in males.…”

Section: Discussionmentioning

confidence: 85%

“…[4][5][6] Few studies have examined the prevalence of FAI morphology in the asymptomatic pediatric population. [7][8][9] While some studies reported cam morphology in children as young as 10 years and pincer morphology in children as early as 12 years of age, 7 other studies demonstrated cam morphology exclusively in adolescents with closed physes. 9 The pathogenesis of FAI is unclear.…”

Section: Discussionmentioning

confidence: 99%

“…[7][8][9] While some studies reported cam morphology in children as young as 10 years and pincer morphology in children as early as 12 years of age, 7 other studies demonstrated cam morphology exclusively in adolescents with closed physes. 9 The pathogenesis of FAI is unclear. Pediatric hip conditions, such as slipped capital femoral epiphysis and Legg-Calve´-Perthes disease, can result in FAI.…”

Section: Discussionmentioning

confidence: 99%

“…[7][8][9] Monazzam and colleagues reported cam morphology in 10.2% of males and 2.5% of females on CT evaluation. Cam and pincer morphologies were seen in children as early as 10 and 12 years of age, respectively.…”

Section: Discussionmentioning

confidence: 99%

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Prevalence of Femoroacetabular Impingement Morphology in Asymptomatic Adolescents

Helvie

Mead

et al. 2017

Journal of Pediatric Orthopaedics

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Section: Discussionmentioning

confidence: 58%

Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Prevalence of Femoroacetabular Impingement Morphology in Asymptomatic Adolescents

Helvie

Mead

et al. 2017

Journal of Pediatric Orthopaedics

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Unravelling the hip pistol grip/cam deformity: Origins to joint degeneration

Beaulé

Grammatopoulos

Speirs

et al. 2018

Journal Orthopaedic Research

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This article reviews a body of work performed by the investigators over 9 years that has addressed the significance of cam morphology in the development of hip osteoarthritis (OA). Early hip joint degeneration is a common clinical presentation and preexisting abnormal joint morphology is a risk factor for its development. Interrogating Hill's criteria, we tested whether cam-type femoroacetabular impingement leads to hip OA. Strength of association was identified between cam morphology, reduced range-of-movement, hip pain, and cartilage degeneration. By studying a pediatric population, we were able to characterize the temporality between cam morphology (occurring 1st) and joint degeneration. Using in silico (finite element) and in vivo (imaging biomarkers) studies, we demonstrated the biological plausibility of how a cam deformity can lead to joint degeneration. Furthermore, we were able to show a biological gradient between degree of cam deformity and extent of articular damage. However, not all patients develop joint degeneration and we were able to characterize which factors contribute to this (specificity). Lastly, we were able to show that by removing the cam morphology, one could positively influence the degenerative process (experiment). The findings of this body of work show consistency and coherence with the literature. Furthermore, they illustrate how cam morphology can lead to early joint degeneration analogous to SCFE, dysplasia, and joint mal-reduction post-injury. The findings of this study open new avenues on the association between cam morphology and OA including recommendations for the study, screening, follow-up, and assessment (patient-specific) of individuals with cam morphology in order to prevent early joint degeneration. Statement of significance: By satisfying Hill's criteria, one can deduct that in some individuals, cam morphology is a cause of OA. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 9999:XX-XX, 2018.

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Measuring 3D growth plate shape: Methodology and application to cam morphology

Horenstein

Meslier

Spada

et al. 2021

Journal Orthopaedic Research

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Physeal changes corresponding to cam morphology are currently measured using two-dimensional (2D) methods. These methods are limited by definitions of the femoral neck axis and head center that are dependent on the radiographic plane of view. To address these limitations, we developed three-dimensional (3D) methods for analyzing continuous growth plate shape using magnetic resonance imaging scans. These new methods rely on a single definition of the femoral neck axis and head center that are both nondependent on the radiographic plane of view and allow for analysis of growth plate shape across the growth plate surface (performed using statistical parametric mapping). Using our 3D method, we analyzed the position of the growth plate in the femoral head (relative to a plane tangent to the femoral head) and the curvature of the growth plate (relative to a plane through the center of the growth plate) in 9-16-year-old males at risk for cam morphology and their recreationally active peers (n = 17/cohort). These two measurements provide an avenue to separately analyze the effects of these variables in the overall growth plate shape. We detected differences in growth plate shape with age in recreationally active adolescents but did not detect differences between at risk and recreationally adolescents.

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The Otto Aufranc Award. On the Etiology of the Cam Deformity: A Cross-sectional Pediatric MRI Study

Abstract: 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.

Cited by 81 publications

References 31 publications

Prevalence of Femoroacetabular Impingement Morphology in Asymptomatic Adolescents

Prevalence of Femoroacetabular Impingement Morphology in Asymptomatic Adolescents

Unravelling the hip pistol grip/cam deformity: Origins to joint degeneration

Measuring 3D growth plate shape: Methodology and application to cam morphology

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