PT - JOURNAL ARTICLE AU - Joshua Heerey AU - Joanne Kemp AU - Rintje Agricola AU - Ramya Srinivasan AU - Anne Smith AU - Tania Pizzari AU - Matthew King AU - Peter Lawrenson AU - Mark Scholes AU - Thomas Link AU - Richard Souza AU - Sharmila Majumdar AU - Kay Crossley TI - Cam morphology is associated with MRI-defined cartilage defects and labral tears: a case–control study of 237 young adult football players with and without hip and groin pain AID - 10.1136/bmjsem-2021-001199 DP - 2021 Dec 01 TA - BMJ Open Sport & Exercise Medicine PG - e001199 VI - 7 IP - 4 4099 - http://bmjopensem.bmj.com/content/7/4/e001199.short 4100 - http://bmjopensem.bmj.com/content/7/4/e001199.full SO - BMJ OPEN SP EX MED2021 Dec 01; 7 AB - Objective Football players are at risk of developing hip osteoarthritis (OA). Cam morphology (present in almost two of every three football players) may explain this heightened risk, but there is limited research on its role in hip OA development in younger athletes. Knowledge of this relationship will advance our understanding of the aetiology of hip OA in football players. We aimed to study the relationship between cam morphology size and MRI-defined cartilage defects and labral tears, and if this relationship differs by symptomatic state in young adult football players.Methods For this case–control study, 182 (288 hips) symptomatic (hip and/or groin pain >6 months and positive flexion-adduction-internal-rotation (FADIR) test) and 55 (110 hips) pain-free football players (soccer or Australian football) underwent anteroposterior and Dunn 45° radiographs, and 3-Tesla MRI. Cam morphology size was defined using alpha angle, and cartilage defects and labral tears were scored semiquantitatively. Presence, location and score (severity) of cartilage defects and labral tears were determined. Each participant completed the International Hip Outcome Tool 33 and Copenhagen Hip and Groin Outcome Score.Results Greater alpha angle was associated with cartilage defects (OR 1.03, 95% CI 1.01 to 1.04) and labral tears (OR 1.02, 95% CI 1.01 to 1.04). Greater alpha angle was associated with superolateral cartilage defects (OR 1.03, 95% CI 1.02 to 1.05) and superior labral tears (OR 1.03, 95% CI 1.02 to 1.05). The association of alpha angle with MRI-defined cartilage defects and labral tears was no greater in football players with symptoms than in those without (p=0.189–0.937)Conclusion Cam morphology size was associated with cartilage defects and labral tears in young adult football players with and without pain. This study provides evidence that cam morphology may contribute to the high prevalence of hip OA in football players. Prospective studies of football players are now needed to establish if cam morphology causes progression of cartilage defects and labral tears and development of hip OA.Data (MRI and patient-reported outcome measures) are available on reasonable request. Suitability of data request and access to data will be determined by the corresponding author.