@article{ref1,
title="A cam deformity is gradually acquired during skeletal maturation in adolescent and young male soccer players: a prospective study with minimum 2-year follow-up",
journal="American journal of sports medicine",
year="2014",
author="Agricola, Rintje and Heijboer, Marinus P. and Ginai, Abida Z. and Roels, Pauline and Zadpoor, Amir Abbas and Verhaar, Jan A. N. and Weinans, Harrie and Waarsing, Jan H.",
volume="42",
number="4",
pages="798-806",
abstract="BACKGROUND: A cam deformity is a major risk factor for hip osteoarthritis, and its formation is thought to be influenced by high-impact sporting activities during growth. <br><br>PURPOSE: To (1) prospectively study whether a cam deformity can evolve over time in adolescents and whether its formation only occurs during skeletal maturation and (2) examine whether clinical or radiographic features can predict the formation of a cam deformity. STUDY DESIGN: Cohort study (prognosis); Level of evidence, 2. <br><br>METHODS: Preprofessional soccer players (N = 63; mean age, 14.43 years; range, 12-19 years) participated both at baseline and follow-up (mean follow-up, 2.4 ± 0.06 years). At both time points, standardized anteroposterior and frog-leg lateral radiographs were obtained. For each hip, the α angle was measured, and the anterosuperior head-neck junction was classified by a 3-point visual system as normal, flattened, or having a prominence. Differences between baseline and follow-up values for the α angle and the prevalence of each visual hip classification were calculated. Additionally, the amount of internal hip rotation, growth plate extension into the neck, and neck shaft angle were determined. <br><br>RESULTS: Overall, there was a significant increase in the prevalence of a cam deformity during follow-up. In boys aged 12 and 13 years at baseline, the prevalence of a flattened head-neck junction increased significantly during follow-up (13.6% to 50.0%; P =.002). In all hips with an open growth plate at baseline, the prevalence of a prominence increased from 2.1% to 17.7% (P =.002). After closure of the proximal femoral growth plate, there was no significant increase in the prevalence or increase in severity of a cam deformity. The α angle increased significantly from 59.4° at baseline to 61.3° at follow-up (P =.018). The amount of growth plate extension was significantly associated with the α angle and hip classification (P =.001). A small neck shaft angle and limited internal rotation were associated with cam deformities and could also significantly predict the formation of cam deformities (α angle >60°) at follow-up. <br><br>CONCLUSION: In youth soccer players, cam deformities gradually develop during skeletal maturation and are probably stable from the time of growth plate closure. The formation of a cam deformity might be prevented by adjusting athletic activities during a small period of skeletal growth, which will have a major effect on the prevalence of hip osteoarthritis.<p /> <p>Language: en</p>",
language="en",
issn="0363-5465",
doi="10.1177/0363546514524364",
url="http://dx.doi.org/10.1177/0363546514524364"
}