Prevalence, topographic and morphometric features of femoral cam-type deformity: changes in relation to age and gender

Abstract

Femoroacetabular impingement (FAI) syndrome is a frequent cause of pain and in recent years considered to be a precursor of premature hip osteoarthritis. The structural abnormalities which characterize FAI syndrome, such as the cam-type deformity, are associated with morphological alterations that may lead to hip osteoarthritis. The aim of this study was to determine the prevalence and topographic and morphometric features of the cam deformity in a series of 326 femur specimens obtained from a Mexican population, as well as changes in prevalence in relation to age and gender. The specimens were subdivided into groups according to gender and age. A standardized photograph of the proximal femur of each specimen was taken, and the photograph was used to determine the alpha angle using a computer program; the location of the lesion was determined by quadrant and the morphometric characteristics were determined by direct observation. The overall prevalence of cam deformities in the femur specimens was 29.8 % (97/326), with a prevalence by gender of 35.2 % (64/182) in men and 22.9 % (33/144) in women. The mean alpha angle was 54.6° ± 8.5° in all of the osteological specimens and 65.6° ± 7.5° in those specimens exhibiting a cam deformity. Cam deformities were found topographically in the anterior-superior quadrant of the femoral head-neck junction in 86.6 % (84/97) of the femurs. Deformities were found in 28.2 % of the right femurs and 31.3 % of the left femurs. The prevalence of cam deformity was higher in the femur specimens of young men and in those of middle-aged and older women. There were no significant differences in this deformity in relation to the alpha angle according to age and gender.

Prevalence of Cam and Pincer Deformities in the X-Rays of Asymptomatic Individuals

“…No correlation between age and α -angle was found. These observations are in line with results from several other studies [ 25 , 30 , 34 , 39 ].…”

“…In recent years, assessment of cam deformities has often been performed by measuring α -angles at the anterior aspect of the femoral head-neck junction [ 5 , 21 , 29 – 31 ]. However, several studies have shown that the area of maximum extension of the cam deformity may vary between patients and that the greatest loss of head-neck asphericity is present at either the anterior aspect of the head-neck junction or the anterior-superior surface [ 32 – 34 ]. As a result, a straight axial X-ray of the femoral head-neck junction may underproject the maximum extension of the cam deformity in some cases.…”

Epidemiology of Hip and Groin Injuries in Collegiate Athletes in the United States

“…For example, prior studies have suggested that anatomic differences in female hips, such as a lower prevalence of cam-type deformities, may help protect against some types of hip injuries. 21,22,29,36,39,41 Another important consideration in sex-related injury discrepancies is the impact of the female athlete triad, which may also help explain the increased number of overuse injuries in female athletes. 27 When analyzing the length of time lost and the severity of injury, some interesting patterns emerge.…”

Prevalence of Morphological Variations Associated With Femoroacetabular Impingement According to Age and Sex: A Study of 1878 Asymptomatic Hips in Nonprofessional Athletes

“…These findings confirm previous data reported by our research team in contemporary osteological specimens with known sex and age. 32 Nonetheless, these suggestions should be confirmed with more comprehensive and longitudinal studies.…”