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This study describes its associations with clinical and imaging features of hip OA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Anteroposterior hip radiographs of 1019 participants from the Tasmanian Older Adult Cohort (TASOAC) were scored at baseline for \u03b1 angle (cam morphology) in both hips. Using the Altman's atlas, radiographic hip OA (ROA) was assessed at baseline. Hip pain and right hip structural changes were assessed on a subset of 245 magnetic resonance images (MRI) at 5\u00a0years. Joint registry data for total hip replacement (THR) was acquired 14\u00a0years from baseline.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 1906 images, cam morphology was assessed in 1016 right and 890 left hips. Cross\u2010sectionally, cam morphology modestly associated with age (prevalence ratio [PR]: 1.02 <jats:italic>P<\/jats:italic>\u00a0=\u00a0.03) and body mass index (BMI) (PR: 1.03\u20101.07, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.03) and strongly related to male gender (PR: 2.96, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001). Radiographically, cam morphology was prevalent in those with decreased joint space (PR: 1.30 <jats:italic>P<\/jats:italic>\u00a0=\u00a0.03) and osteophytes (PR: 1.47, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.03). Longitudinally, participants with right cam and high BMI had more hip pain (PR: 17.9, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.02). At the end of 5\u00a0years of follow\u2010up these participants were also more likely to have structural changes such as bone marrow lesions (BMLs) (PR: 1.90 <jats:italic>P<\/jats:italic>\u00a0=\u00a0.04), cartilage defects (PR: 1.26, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.04) and effusion\u2010synovitis at multiple sites (PR: 1.25 <jats:italic>P<\/jats:italic>\u00a0=\u00a0.02). Cam morphology at baseline in either hip predicted up to threefold risk of THR (PR: 3.19, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.003) at the end of 14\u00a0years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>At baseline, cam morphology was linked with age, higher weight, male gender, early signs of radiographic OA such as joint space narrowing (JSN) and osteophytes (OST). At follow\u2010up, cam predicted development of hip BMLs, hip effusion\u2010synovitis, cartilage damage and THR. These findings suggest that cam morphology plays a significant role in early OA and can be a precursor or contribute to hip OA in later life.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1756-185x.14313","type":"journal-article","created":{"date-parts":[[2022,3,9]],"date-time":"2022-03-09T09:35:00Z","timestamp":1646818500000},"page":"601-612","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["A prospective cohort study on cam morphology and its role in progression of osteoarthritis"],"prefix":"10.1111","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5901-4720","authenticated-orcid":false,"given":"Harbeer","family":"Ahedi","sequence":"first","affiliation":[{"name":"Menzies Institute for Medical Research University of Tasmania  Hobart Tas Australia"},{"name":"Faculty of Medicine and Health Institute for Musculoskeletal Health University of Sydney  Camperdown NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tania","family":"Winzenberg","sequence":"additional","affiliation":[{"name":"Menzies Institute for Medical Research University of Tasmania  Hobart Tas Australia"},{"name":"Faculty of Health University of Tasmania  Hobart Tas Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sita","family":"Bierma\u2010Zeinstra","sequence":"additional","affiliation":[{"name":"Erasmus MC University Medical Centre  Rotterdam The Netherlands"},{"name":"Department of Orthopaedics  Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leigh","family":"Blizzard","sequence":"additional","affiliation":[{"name":"Menzies Institute for Medical Research University of Tasmania  Hobart Tas Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marienke","family":"van Middelkoop","sequence":"additional","affiliation":[{"name":"Erasmus MC University Medical Centre  Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rintje","family":"Agricola","sequence":"additional","affiliation":[{"name":"Erasmus MC University Medical Centre  Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan H.","family":"Waarsing","sequence":"additional","affiliation":[{"name":"Erasmus MC University Medical Centre  Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flavia","family":"Cicuttini","sequence":"additional","affiliation":[{"name":"DEPM Monash University  Melbourne Vic. 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