Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, UK.
Southampton Football Club, Southampton, UK.
Br J Sports Med. 2018 May;52(9):601-610. doi: 10.1136/bjsports-2017-097626. Epub 2017 Aug 10.
Cam morphology is a strong risk factor for the development of hip pain and osteoarthritis. It is increasingly thought to develop in association with intense physical activity during youth; however, the aetiology remains uncertain. The study aim was to characterise the effect of physical activity on morphological hip development during adolescence.
Cross-sectional study of individuals aged 9-18 years recruited from Southampton Football Club Academy (103 male) with an age-matched control population (52 males and 55 females). Assessments included questionnaires and 3 Tesla MRI of both hips. Alpha angle, epiphyseal extension and epiphyseal tilt were measured on radial images.
Alpha angle and epiphyseal extension increased most rapidly between ages 12 and 14 years. Soft-tissue hypertrophy at the femoral head-neck junction preceded osseous cam morphology and was first evident at age 10 years. The greatest increase and highest absolute values of alpha angle and epiphyseal extension were colocalised at 1 o'clock. Maximum alpha angles were 6.7 degrees greater in males than females (p=0.005). Compared with individuals who play no regular sport, alpha angles were 4.0 degrees higher in individuals who play sport for a school or club (p=0.041) and 7.7 degrees higher in individuals competing at a national or international level (p=0.035). There was no association with leg dominance .
Sporting activity during adolescence is strongly associated with the development of cam morphology secondary to epiphyseal hypertrophy and extension with a dose-response relationship. Males participating in competitive sport are at particularly elevated risk of developing cam morphology and secondary hip pathology.
髋臼形态是导致髋关节疼痛和骨关节炎的一个重要危险因素。越来越多的研究认为，这种形态在青少年时期剧烈的体育活动中发展而来；然而，其病因仍不确定。本研究旨在描述青少年时期的体育活动对髋关节形态发育的影响。
本研究为横断面研究，共招募了来自南安普顿足球俱乐部学院的 103 名男性（年龄 9-18 岁）和年龄匹配的对照组（52 名男性和 55 名女性）。评估包括问卷调查和双侧髋关节 3T MRI。在放射状图像上测量 alpha 角、骺板延伸和骺板倾斜。
alpha 角和骺板延伸在 12-14 岁之间增加最快。股骨头-颈交界处的软组织肥大先于骨cam 形态，并在 10 岁时首次出现。alpha 角和骺板延伸的增加最大且绝对值最高，位于 1 点钟位置。男性的 alpha 角比女性大 6.7 度（p=0.005）。与不参加任何常规运动的个体相比，参加学校或俱乐部运动的个体的 alpha 角高 4.0 度（p=0.041），参加国家或国际水平比赛的个体的 alpha 角高 7.7 度（p=0.035）。与腿优势无关。
青少年时期的体育活动与骺板肥大和延伸导致的 cam 形态发育密切相关，呈剂量反应关系。参与竞技运动的男性发生 cam 形态和继发性髋关节病变的风险特别高。
