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Cam impingement of the hip—a risk factor for hip osteoarthritis

Nature Reviews Rheumatology volume 9, pages 630–634 (2013)Cite this article

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Abstract

Femoroacetabular impingement (FAI) is characterized by abnormal contact between the proximal femur and the acetabulum. Two subtypes have been described: pincer impingement, caused by an overcovered acetabulum; and cam impingement, which occurs as a result of an aspherical femoral head (cam abnormality). A strong correlation exists between cam impingement and the subsequent development of hip osteoarthritis (OA). Major cam abnormalities confer a high risk of OA. However, the association between cam abnormalities and the pathology of OA has been difficult to compare between studies, as different methods have been used to define the abnormality. Cam abnormalities are acquired during skeletal growth and could be influenced by high impact sporting activities. Preventative treatments aiming to reduce the incidence of cam abnormalities and subsequent OA could, therefore, be developed. In this Perspective, we discuss the current understanding of FAI, focusing on cam abnormalities and their association with OA.

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Figure 1: Mechanism of cam impingement.
Figure 2: Formation of a cam abnormality.

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Author notes

  1. R. Agricola r.agricola@erasmusmc.nl

Authors and Affiliations

  1. Department of Orthopaedics, Erasmus MC University Medical Centre, Room EE16–18, Dr Molewaterplein 50, Rotterdam, 3015 GE, Netherlands

    Rintje Agricola, Jan H. Waarsing & Sita M. A. Bierma-Zeinstra

  2. Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Nuffield Orthopaedic Centre, Windmill Road, Headington, Oxford, OX3 7LD, UK

    Nigel K. Arden, Andrew J. Carr, Geraint E. Thomas & Sion Glyn-Jones

  3. Department of Orthopaedics and Rheumatology, University Medical Centre Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, G05.228, HP, Netherlands

    Harrie Weinans

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Contributions

R. Agricola, G. E. Thomas and S. Glyn-Jones researched data for the article. R. Agricola, G. E. Thomas, S. Glyn-Jones, J. H. Waarsing, N. K. Arden, S. M. A. Bierma-Zeinstra and H. Weinans made substantial contributions to discussing content and writing the article. All authors reviewed and edited the manuscript.

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The authors declare no competing financial interests.

Supplementary information

Supplementary Table 1

Studies examining α angle (DOC 69 kb)

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Agricola, R., Waarsing, J., Arden, N. et al. Cam impingement of the hip—a risk factor for hip osteoarthritis. Nat Rev Rheumatol 9, 630–634 (2013). https://doi.org/10.1038/nrrheum.2013.114

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