How does the cam morphology develop in athletes? A systematic review and meta-analysis

Area of Science:

• Orthopedics
• Sports Medicine
• Developmental Biology

Background:

• Cam morphology is more prevalent in athletes, but its developmental timeline is unclear.
• Understanding cam morphology development is crucial for addressing athletic hip conditions.

Purpose of the Study:

• To determine the developmental timing of cam morphology in athletes.
• To identify associated proximal femoral morphologies and other contributing factors.

Main Methods:

• Systematic review of Embase, MEDLINE, and Cochrane Library.
• PRISMA guidelines followed, with random effects meta-analysis.
• Study quality assessed using Downs and Black criteria; evidence quality using GRADE framework.

Main Results:

• 16 articles with 2,028 participants analyzed.
• In males, higher alpha angle observed in athletes with closed physes.
• Cam morphology prevalence correlated with adolescent age and lateral epiphyseal extension; dose-response with sporting frequency.

Conclusions:

• Osseous cam morphology in most adolescent male athletes develops during skeletal immaturity.
• Prevalence increases with age and is linked to proximal femoral epiphyseal development.