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Most plants use the C3 pathway for carbon fixation. However, some plants, such as sugar cane, corn, and cacti that grow in hot conditions, use alternative pathways to fix carbon and conserve energy loss due to photorespiration. Photorespiration is the process that occurs when the oxygen concentration is high. Under such conditions, the rubisco enzyme in the Calvin cycle binds O2 instead of CO2, which halts photosynthesis and consumes energy.
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Classifying Cam Morphology by the Alpha Angle: A Systematic Review on Threshold Values.

Pim van Klij1, Michael P Reiman2, Jan H Waarsing1

  • 1Department of Orthopaedic Surgery, Erasmus MC, University Medical Center Rotterdam, the Netherlands.

Orthopaedic Journal of Sports Medicine
|August 27, 2020
PubMed
Summary
This summary is machine-generated.

An alpha angle threshold of 60° is recommended for classifying cam morphology, based on a systematic review. This threshold is most appropriate, though further research is needed for full validation.

Keywords:
alpha anglecam morphologydiagnosisfemoroacetabular impingement syndromehip

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Area of Science:

  • Orthopedics
  • Radiology
  • Biomechanical analysis

Background:

  • Cam morphology is frequently assessed using the alpha angle.
  • Current literature lacks consensus on the optimal alpha angle threshold for classification.
  • This variability impacts diagnostic accuracy and treatment strategies.

Purpose of the Study:

  • To systematically review alpha angle threshold values used for defining cam morphology.
  • To assess the consistency of data for establishing a definitive alpha angle threshold.
  • To provide evidence-based guidance for classifying cam morphology.

Main Methods:

  • Systematic review of studies identifying alpha angle thresholds.
  • Searched Embase, Medline, Web of Science, Cochrane Central, and Google Scholar databases.
  • Included case-control, cohort, and finite-element studies (Level of evidence, 3).

Main Results:

  • Receiver operating characteristic (ROC) curve analyses suggested thresholds between 57° and 60°.
  • A 60° threshold effectively discriminated cam morphology in a large cohort study.
  • Studies using 95% reference intervals reported wide ranges (58°–93°), varying by sex.

Conclusions:

  • An alpha angle threshold of ≥60° is currently the most appropriate for classifying cam morphology.
  • Evidence primarily from ROC analyses supports this threshold.
  • Further research is necessary to fully validate the proposed alpha angle threshold.