Background/aim: Cam deformity (CD) is likely a bony adaptation in response to high-impact sports practice during skeletal growth. We ascertained whether a dose-response relationship exists between the frequency of football practice during skeletal growth and the presence of a CD in adulthood, and if the age at which a football player starts playing football is associated with the presence of a CD in adulthood. Methods: Prevalence of a CD (α angle>60°) and a pathological CD (α angle>78°) was studied using standardised anteroposterior (AP) and frog-leg lateral (FLL) radiographs that were obtained during seasonal screening. The age of starting to play football with a low frequency (LF; ≤3 times/week) and high frequency (HF; ≥4 times/week) was retrospectively assessed. The differences in prevalence of a CD per hip, in either view, between groups were calculated by logistic regression with generalised estimating equations. Results: 63 players (mean(±SD) age 23.1(±4.2) years) participated, yielding 126 hips for analysis. The prevalence of a CD in the FLL was 40% (n=82) in players who started playing HF football from the age of 12 years or above, and 64% (n=44) in those playing HF football before the age of 12 years (p=0.042). This was also true for a pathological CD (12% vs 30%, p=0.038). The AP views revealed no difference. Conclusions: Our results indicate a probable dose-response relationship between the frequency of football practice during skeletal growth and the development of a CD, which should be confirmed in future prospective studies.

Additional Metadata
Persistent URL dx.doi.org/10.1136/bjsports-2014-094130, hdl.handle.net/1765/79665
Journal British Journal of Sports Medicine: an international peer-reviewed journal of sport and exercise medicine
Citation
Tak, I, Weir, A, Langhout, R, Waarsing, J.H, Stubbe, J.H, Kerkhoffs, J-L.H, & Agricola, R. (2015). The relationship between the frequency of football practice during skeletal growth and the presence of a cam deformity in adult elite football players. British Journal of Sports Medicine: an international peer-reviewed journal of sport and exercise medicine, 49(9), 630–634. doi:10.1136/bjsports-2014-094130