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Prevalence of Cam Femoroacetabular Lesions in Medieval (1200-1600 CE) and Postmedieval (1600-1850 CE) Dutch Skeletal
Nouschka Bosch1, Sarah Schrader1, Daniel Cooperman2
1Faculty of Archeology Leiden University Leiden Netherlands.
Purpose:
To evaluate medieval and postmedieval Dutch skeletal collections for signs of cam impingent.
Methods:
The medieval collections from Alkmaar Paardenmarkt and Klaaskinderkerke and the postmedieval period from Middenbeemster were studied. Standard osteological methods for sex and age estimation were used. From digital photographs of the femora, the apparent neck shaft angle, true neck shaft angle, angles of version and inclination, and the α and β angles of Nötzli were measured with ImageJ software.
Results:
The time spans were ~1448 to 1573 for Alkmaar Paardenmarkt, ~1286 to 1573 for Klaaskinderkerke, and 1615 to 1866 for Middenbeemster. Femora exhibiting signs of trauma, disease, or poor preservation were excluded. There were 116 individuals (186 femora) available for study: 21 individuals (35 femora) from Alkmaar Paardenmarkt, 38 individuals (52 femora) from Klaaskinderkerke, and 57 individuals (99 femora) from Middenbeemster. There were 104 male and 68 female femora (sex not known in 14). Using an α angle of ≥50°, ≥55°, and ≥60°, the prevalence of cam deformity was 25%, 16%, and 10%, respectively. The cam deformity prevalence (α ≥ 50°) was higher in the medieval group (39%) than the postmedieval group (13%) (P < .001) and in male individuals (35%) compared with females (9%) (P < .001). The prevalence of cam deformity was 46% in Klaaskinderkerke, 29% in the Alkmaar Paardenmarkt, and 13% in the Middenbeemster collection (P < .001). There were no differences by laterality, paired/unpaired femora, or individual/comingled burials. The prevalence of cam deformity correlated with the physical activities of the individuals. The highest prevalence was in the Klaaskinderkerke (46%) collection and soldiers (62%) from the Alkmaar Paardenmarkt collection. With increasing urbanization and a concomitant decrease in self-sufficiency, the prevalence dropped to 13% in the Middenbeemster collection.
Conclusions:
Cam deformities that correlate with physical activity levels were found in historical Dutch skeletal specimens.
Clinical Relevance:
Cam deformity is considered an adaptive response to modern athletic activity. Evaluation of historical specimens will provide a fuller understanding of this condition by revealing whether cam deformity was present in historical skeletal specimens.
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