title: What Is the Association Between Sports Participation and the Development of Proximal Femoral Cam Deformity? A Systematic Review and Meta-analysis.
abstract: BACKGROUND
  Femoroacetabular impingement (FAI) is recognized as a common cause of hip pain and intra-articular disorders in athletes. Studies have suggested a link between participation in athletics during adolescence and the development of cam-type deformities of the proximal femoral head-neck junction.
  
  
  OBJECTIVE
  To investigate the association of sporting activity participation during adolescence and the development of cam deformity.
  
  
  METHODS
  Systematic review.
  
  
  METHODS
  The PubMed, EMBASE, and Cochrane databases were searched to identify potential studies. Abstracts and manuscripts (when applicable) were independently reviewed by 2 reviewers. Nine studies met the inclusion criteria, including 8 studies that compared the prevalence of cam deformity in athletes with that in controls and 3 studies that compared the prevalence of cam deformity before and after physeal closure (2 with both). A meta-analysis was performed with pooling of data and random-effects modeling to compare rates of cam deformity between athletes and controls.
  
  
  RESULTS
  High-level male athletes are 1.9 to 8.0 times more likely to develop a cam deformity than are male controls. The pooled prevalence rate (by hip) of cam deformity in male athletes was 41%, compared with 17% for male controls. The pooled mean alpha angle among male athletes was 61°, compared with 51° for male controls.
  
  
  CONCLUSIONS
  Males participating in specific high-level impact sports (hockey, basketball, and possibly soccer) are at an increased risk of physeal abnormalities of the anterosuperior head-neck junction that result in a cam deformity at skeletal maturity.
authors.affiliation: Department of Orthopaedic Surgery, Washington University School of Medicine, St Louis, Missouri, USA nepplej@wudosis.wustl.edu.
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Nepple
authors.affiliation: Department of Orthopaedic Surgery, New York University-Hospital for Joint Diseases, New York, New York, USA.
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Vigdorchik
authors.affiliation: Department of Orthopaedic Surgery, Washington University School of Medicine, St Louis, Missouri, USA.
authors.forename: John C
authors.initials: JC
authors.lastname: Clohisy
mesh_terms: D000293:Adolescent; D056352:Athletes; D057925:Femoracetabular Impingement / Q000453:epidemiology*; D005270:Femur Head / Q000473:pathology; D005272:Femur Neck / Q000473:pathology; D006132:Growth Plate; D006621:Hip Joint / Q000473:pathology*; D006801:Humans; D008297:Male; D010146:Pain / Q000209:etiology; D015995:Prevalence
keywords: basketball; femoroacetabular impingement; hip; ice hockey