Prevalence of Cam Deformity with Associated Femoroacetabular Impingement Syndrome in Hip Joint Computed Tomography of Asymptomatic Adults

Abstract

PURPOSE: Femoroacetabular impingement (FAI) is considered an important cause of early degenerative arthritis development. Although three-dimensional (3D) imaging such as computed tomography (CT) and magnetic resonance imaging are considered precise imaging modalities for 3D morphology of FAI, they are associated with several limitations when used in out-patient clinics. The paucity of FAI morphologic data in Koreans makes it difficult to select the most effective radiographical method when screening for general orthopedic problems. We postulate that there might be an individual variation in the distribution of cam deformity in the asymptomatic Korean population. MATERIALS AND METHODS: From January 2011 to December 2015, CT images of the hips of 100 subjects without any history of hip joint ailments were evaluated. A computer program which generates 3D models from CT scans was used to provide sectional images which cross the central axis of the femoral head and neck. Alpha angles were measured in each sectional images. Alpha angles above 55 degrees were regarded as cam deformity. RESULTS: The mean alpha angle was 43.5 degrees , range 34.7-56.1 degrees (3 o'clock); 51.24 degrees , range 39.5-58.8 degrees (2 o'clock); 52.45 degrees , range 43.3-65.5 degrees (1 o'clock); 44.09 degrees , range 36.8-49.8 degrees (12 o'clock); 40.71, range 33.5-45.8 degrees (11 o'clock); and 39.21 degrees , range 34.1-44.6 degrees (10 o'clock). Alpha angle in 1 and 2 o'clock was significantly larger than other locations (P<0.01). The prevalence of cam deformity was 18.0% and 19.0% in 1 and 2 o'clock, respectively. CONCLUSION: Cam deformity of FAI was observed in 31% of asymptomatic hips. The most common region of cam deformity was antero-superior area of femoral head-neck junction (1 and 2 o'clock).