Origin of Cam Morphology in Femoroacetabular Impingement.
Cam morphology of the proximal femur is an abnormal contour of the femoral head-neck junction present in approximately 15% to 25% of the asymptomatic population, predominantly in males. Alpha angle and femoral head-neck offset ratio are 2 objective measurement tools that define cam morphology. Both primary (idiopathic) and secondary cam deformity develops through distinct mechanisms. The cause of primary (idiopathic) cam morphology remains incompletely understood. Mounting evidence suggests that idiopathic cam morphology develops during adolescence through alterations in the capital femoral epiphysis in response to participation in vigorous sporting activity. While the exact cause of epiphyseal extension has not yet been determined, preliminary evidence suggests that epiphyseal extension may reflect a short-term adaptive response to provide stability to the physis at the long-term cost of the development of cam morphology. Commonly recognized causes of secondary cam deformity include frank slipped capital femoral epiphysis, Legg-Calve-Perthes disease, and deformity after fracture of the proximal femur. Recent studies also support subtle slipped capital femoral epiphysis as a unique and silent cause of a small percentage of subjects previously thought to have idiopathic cam deformity.
Department of Orthopaedic Surgery, University Hospitals, Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio, USA.
William Z
WZ
Morris
Department of Orthopaedic Surgery, University Hospitals, Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio, USA.
Ryan T
RT
Li
Division of Pediatric Orthopaedics, Rainbow Babies and Children's Hospitals at Case Western Reserve University, Cleveland, Ohio, USA.
Raymond W
RW
Liu
University Hospitals Sports Medicine Institute, Cleveland, Ohio, USA.
Michael J
MJ
Salata
University Hospitals Sports Medicine Institute, Cleveland, Ohio, USA.
James E
JE
Voos
D004838:Epiphyses / Q000473:pathology; D005260:Female; D057925:Femoracetabular Impingement / Q000209:etiology*; D005270:Femur Head / Q000473:pathology*; D005272:Femur Neck / Q000473:pathology*; D006621:Hip Joint / Q000473:pathology; D006801:Humans; D008297:Male; D060048:Slipped Capital Femoral Epiphyses / Q000209:etiology*
FAI; cam morphology; cam-type deformity; femoroacetabular impingement; hip