{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T16:53:32Z","timestamp":1791910412371,"version":"4.3.4"},"reference-count":26,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:00:00Z","timestamp":1791849600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:00:00Z","timestamp":1791849600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["esskajournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Cam\u2010type femoroacetabular impingement (FAI) is a recognised structural contributor to primary hip osteoarthritis (OA), yet many cam\u2010positive hips do not progress to radiographic joint failure. This study aimed to compare three\u2010dimensional cam morphology and lesion location between cam\u2010positive hips with end\u2010stage primary osteoarthritis and cam\u2010positive, non\u2010arthritic hips in an elderly fracture cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Hospital records and imaging archives from January 2020 to January 2026 were retrospectively reviewed at a single centre. The OA group comprised patients undergoing total hip arthroplasty for primary OA, and the fracture group comprised patients aged\u2009\u2265\u200965 years treated for intertrochanteric or subtrochanteric femoral fractures without radiographic OA. Cam morphology was characterised using radial CT\u2010based alpha angle, three\u2010dimensional cam volume, cam\/head volume ratio, and clock\u2010face\u2013based lesion location. Group comparisons, receiver operating characteristic analyses, correlation testing, and multivariable logistic regression were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 438 cam\u2010positive hips were included (126 OA and 312 fracture). OA hips demonstrated higher alpha angles (72.44\u00b0\u2009\u00b1 5.94\u00b0 vs. 62.45\u00b0\u2009\u00b1\u20095.07\u00b0), larger cam volumes (5274.77\u2009\u00b1\u20091353.26\u2009mm\n                      <jats:sup>3<\/jats:sup>\n                      vs. 3215.20\u2009\u00b1\u20091524.84\u2009mm\n                      <jats:sup>3<\/jats:sup>\n                      ), higher cam\/head ratios (8.61%\u2009\u00b1\u20092.02% vs. 6.35%\u2009\u00b1\u20091.97%), and more superolateral lesions (52.4% vs. 36.2% anterior in the fracture group) (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Exploratory receiver operating characteristic analyses identified cohort\u2010specific discriminatory values of 66\u00b0 for alpha angle (AUC, 0.884), 4421\u2009mm\n                      <jats:sup>3<\/jats:sup>\n                      for cam volume (AUC, 0.839), and 6.4% for the cam\u2010to\u2010head volume ratio (AUC, 0.791). In multivariable analyses using continuous morphology measures, higher alpha angle, greater cam volume, higher cam\u2010to\u2010head volume ratio, and superolateral lesion location were associated with end\u2010stage OA\u2010group membership.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Compared with non\u2010arthritic cam\u2010positive hips in an elderly fracture cohort, end\u2010stage primary OA hips had greater three\u2010dimensional cam burden, with lesions more often located superolaterally. These retrospective associations do not establish longitudinal progression, causality, or individual prognosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Retrospective comparative study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level III, study of a non\u2010consecutive patients, study of diagnostic test.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ksa.70646","type":"journal-article","created":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T16:32:39Z","timestamp":1791909159000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Greater three\u2010dimensional cam burden and superolateral location are associated with end\u2010stage hip osteoarthritis: A retrospective comparative study"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7952-4223","authenticated-orcid":false,"given":"Servet","family":"Igrek","sequence":"first","affiliation":[{"name":"Department of Orthopaedics and Traumatology Hisar Intercontinental Hospital Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9708-5351","authenticated-orcid":false,"given":"Okan","family":"Yigit","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology Kartal Dr. Lutfi Kirdar City Hospital Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9197-2942","authenticated-orcid":false,"given":"Sebati Baser","family":"Canbaz","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology Kartal Dr. Lutfi Kirdar City Hospital Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-3380-1181","authenticated-orcid":false,"given":"Husnu","family":"Yilmaz","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology Kartal Dr. Lutfi Kirdar City Hospital Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3966-4184","authenticated-orcid":false,"given":"Emrah Gokay","family":"Ozgur","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Marmara University School of Medicine Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2453-0869","authenticated-orcid":false,"given":"Engin","family":"Eceviz","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology Kartal Dr. Lutfi Kirdar City Hospital Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2537-0660","authenticated-orcid":false,"given":"Baris","family":"Kocaoglu","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology Acibadem University Faculty of Medicine Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,13]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.1136\/bjsports-2024-108222","article-title":"Femoroacetabular impingement syndrome in middle\u2010aged individuals is strongly associated with the development of hip osteoarthritis within 10\u2010year follow\u2010up: a prospective cohort study (CHECK)","volume":"58","author":"Agricola R","year":"2024","journal-title":"Br J Sports Med"},{"key":"e_1_2_12_3_1","doi-asserted-by":"crossref","first-page":"918","DOI":"10.1136\/annrheumdis-2012-201643","article-title":"Cam impingement causes osteoarthritis of the hip: a nationwide prospective cohort study (CHECK)","volume":"72","author":"Agricola R","year":"2013","journal-title":"Ann Rheum Dis"},{"key":"e_1_2_12_4_1","doi-asserted-by":"crossref","first-page":"921","DOI":"10.1007\/s00256-010-1021-2","article-title":"Development of a three\u2010dimensional detection method of cam deformities in femoroacetabular impingement","volume":"40","author":"Audenaert EA","year":"2011","journal-title":"Skeletal Radiol"},{"key":"e_1_2_12_5_1","first-page":"581","article-title":"Occupational strain as a risk for hip osteoarthritis","volume":"114","author":"Bergmann A","year":"2017","journal-title":"Dtsch Arztebl Int"},{"key":"e_1_2_12_6_1","doi-asserted-by":"crossref","first-page":"810","DOI":"10.1016\/j.arthro.2023.08.004","article-title":"A superolateral cam lesion location increases odds of total hip arthroplasty 5 years after hip arthroscopy","volume":"40","author":"Buldo\u2010Licciardi M","year":"2024","journal-title":"Arthroscopy"},{"key":"e_1_2_12_7_1","doi-asserted-by":"crossref","first-page":"3431","DOI":"10.1007\/s00330-018-5968-z","article-title":"Cam\u2010type femoroacetabular impingement\u2010correlations between alpha angle versus volumetric measurements and surgical findings","volume":"29","author":"Dessouky R","year":"2019","journal-title":"Eur Radiol"},{"key":"e_1_2_12_8_1","doi-asserted-by":"crossref","first-page":"1283","DOI":"10.1007\/s00167-019-05383-9","article-title":"Total volume of cam deformity alone predicts outcome in arthroscopy for femoroacetabular impingement","volume":"28","author":"Ellis SH","year":"2020","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"e_1_2_12_9_1","doi-asserted-by":"crossref","first-page":"4566","DOI":"10.1016\/j.arthro.2025.05.028","article-title":"Body mass index, sex, t\u00f6nnis and outerbridge grades, but not cam lesion location, influence 10\u2010year outcomes after hip arthroscopy for femoroacetabular impingement syndrome","volume":"41","author":"Gosnell GG","year":"2025","journal-title":"Arthroscopy"},{"key":"e_1_2_12_10_1","doi-asserted-by":"crossref","first-page":"2436","DOI":"10.2106\/JBJS.J.01280","article-title":"Prevalence of cam\u2010type femoroacetabular impingement morphology in asymptomatic volunteers","volume":"92","author":"Hack K","year":"2010","journal-title":"J Bone Joint Surg\u2010Am Vol"},{"key":"e_1_2_12_11_1","doi-asserted-by":"crossref","first-page":"11906","DOI":"10.3390\/ijms231911906","article-title":"Mendelian randomization studies of lifestyle\u2010related risk factors for osteoarthritis: a PRISMA review and meta\u2010analysis","volume":"23","author":"Ho J","year":"2022","journal-title":"Int J Mol Sci"},{"key":"e_1_2_12_12_1","doi-asserted-by":"crossref","first-page":"4579","DOI":"10.1016\/j.arthro.2025.07.019","article-title":"Editorial commentary: cam lesion location and size in hip arthroscopy: which matters most?","volume":"41","author":"Huang H","year":"2025","journal-title":"Arthroscopy"},{"key":"e_1_2_12_13_1","doi-asserted-by":"crossref","first-page":"1167","DOI":"10.1302\/0301-620X.96B9.33555","article-title":"Evaluation of the magnitude and location of Cam deformity using three dimensional CT analysis","volume":"96","author":"Khan O","year":"2014","journal-title":"Bone Joint J"},{"key":"e_1_2_12_14_1","doi-asserted-by":"crossref","first-page":"1539","DOI":"10.1016\/j.arthro.2024.08.032","article-title":"Alpha angle values predict the severity of hip chondral damage in patients with cam\u2010type femoroacetabular impingement syndrome: a systematic review and meta\u2010analysis","volume":"41","author":"Martins EC","year":"2025","journal-title":"Arthroscopy"},{"key":"e_1_2_12_15_1","doi-asserted-by":"crossref","first-page":"2011","DOI":"10.1007\/s00330-016-4530-0","article-title":"Cam deformity and the omega angle, a novel quantitative measurement of femoral head\u2010neck morphology: a 3D CT gender analysis in asymptomatic subjects","volume":"27","author":"Mascarenhas VV","year":"2017","journal-title":"Eur Radiol"},{"key":"e_1_2_12_16_1","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1302\/0301-620X.84B4.0840556","article-title":"The contour of the femoral head\u2010neck junction as a predictor for the risk of anterior impingement","volume":"84","author":"N\u00f6tzli HP","year":"2002","journal-title":"J Bone Joint Surg Br"},{"key":"e_1_2_12_17_1","doi-asserted-by":"crossref","first-page":"e1291","DOI":"10.5435\/JAAOS-D-22-00125","article-title":"AAOS clinical practice guideline summary: management of hip fractures in older adults","volume":"30","author":"O'Connor MI","year":"2022","journal-title":"J Am Acad Orthop Surg"},{"key":"e_1_2_12_18_1","doi-asserted-by":"crossref","first-page":"666","DOI":"10.1002\/ksa.70259","article-title":"Mid\u2010 to long\u2010term outcomes of capsular management in hip arthroscopy for FAIS: a multilevel meta\u2010analysis","volume":"34","author":"Ramadanov N","year":"2026","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"e_1_2_12_19_1","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1002\/ksa.70094","article-title":"Capsular management strategies in hip arthroscopy for femoroacetabular impingement syndrome: a multilevel meta\u2010analysis","volume":"34","author":"Ramadanov N","year":"2026","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"e_1_2_12_20_1","doi-asserted-by":"crossref","first-page":"2980","DOI":"10.1177\/03635465221111565","article-title":"Association of cam deformity on anteroposterior pelvic radiographs and more severe chondral damage in femoroacetabular impingement syndrome","volume":"50","author":"Rogers MJ","year":"2022","journal-title":"Am J Sports Med"},{"key":"e_1_2_12_21_1","doi-asserted-by":"crossref","first-page":"514","DOI":"10.1148\/radiol.12112479","article-title":"How useful is the alpha angle for discriminating between symptomatic patients with cam\u2010type femoroacetabular impingement and asymptomatic volunteers?","volume":"264","author":"Sutter R","year":"2012","journal-title":"Radiology"},{"key":"e_1_2_12_22_1","doi-asserted-by":"crossref","first-page":"1179","DOI":"10.1016\/j.arthro.2021.08.024","article-title":"Preoperative alpha angles can predict severity of acetabular rim chondral damage in symptomatic cam\u2010type femoroacetabular impingement: a prospective observatory study","volume":"38","author":"Tang HC","year":"2022","journal-title":"Arthroscopy"},{"key":"e_1_2_12_23_1","doi-asserted-by":"crossref","first-page":"1796","DOI":"10.1016\/j.arthro.2018.12.031","article-title":"Do your routine radiographs to diagnose cam femoroacetabular impingement visualize the region of the femoral head\u2010neck junction you intended?","volume":"35","author":"Uemura K","year":"2019","journal-title":"Arthroscopy"},{"key":"e_1_2_12_24_1","doi-asserted-by":"crossref","first-page":"961","DOI":"10.1177\/0363546516656359","article-title":"What is the association of elite sporting activities with the development of hip osteoarthritis?","volume":"45","author":"Vigdorchik JM","year":"2017","journal-title":"Am J Sports Med"},{"key":"e_1_2_12_25_1","doi-asserted-by":"crossref","first-page":"3036","DOI":"10.1177\/0363546517719460","article-title":"Cam deformities and limited hip range of motion are associated with early osteoarthritic changes in adolescent athletes: a prospective matched cohort study","volume":"45","author":"Wyles CC","year":"2017","journal-title":"Am J Sports Med"},{"key":"e_1_2_12_26_1","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1007\/s40520-025-03035-2","article-title":"Revealing the mediating mechanisms between BMI and osteoarthritis: a Mendelian randomization and mediation analysis","volume":"37","author":"Yu H","year":"2025","journal-title":"Aging Clin Exp Res"},{"key":"e_1_2_12_27_1","doi-asserted-by":"crossref","first-page":"20180371","DOI":"10.1259\/bjr.20180371","article-title":"3D CT segmentation of CAM type femoroacetabular impingement\u2010reliability and relationship of CAM lesion with anthropomorphic features","volume":"91","author":"Zhang L","year":"2018","journal-title":"Br J Radiol"}],"container-title":["Knee Surgery, Sports Traumatology, Arthroscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ksa.70646","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ksa.70646","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ksa.70646","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T16:32:42Z","timestamp":1791909162000},"score":1,"resource":{"primary":{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/10.1002\/ksa.70646"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,13]]},"references-count":26,"alternative-id":["10.1002\/ksa.70646"],"URL":"https:\/\/doi.org\/10.1002\/ksa.70646","archive":["Portico"],"relation":{},"ISSN":["0942-2056","1433-7347"],"issn-type":[{"value":"0942-2056","type":"print"},{"value":"1433-7347","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,13]]},"assertion":[{"value":"2026-08-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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