Associated Factors of Primary Cam Morphology in 4477 Early Adolescents: A Multiethnic, Population-Based, Cross-sectional Study (Generation R)
Bibliographic record
Abstract
Background: Multiple prospective cohort studies have consistently shown a strong association between cam morphology and the development of hip osteoarthritis. However, associated factors of primary cam morphology (PCM) in the general adolescent population remain largely unexplored. Purpose: To investigate associated factors of the presence of PCM and increased alpha angle in early adolescents from the general population. Study Design: Cross-sectional study; Level of evidence, 3. Methods: The authors included 4477 participants with high-resolution dual-energy x-ray absorptiometry scans of the right hip from the population-based Generation R cohort in Rotterdam, the Netherlands. The alpha angle was automatically measured using validated methods. PCM was defined as an alpha angle ≥60°. The authors used multivariable logistic and linear regression models to investigate factors (demographic, anthropometric, and lifestyle factors and proximal femoral physis status) associated with PCM and increased alpha angle, respectively. Results: Of the included participants (median age, 13.5 years [2.5th-97.5th percentile, 13.2-14.6]; 51.6% female, 73.7% European), 151 (3.4%) had PCM. Male sex (adjusted odds ratio [aOR], 2.56; 95% CI, 1.62-4.04) and closed proximal femoral physis (aOR 3.28; 95% CI, 2.05-5.24) were associated with higher odds of PCM, whereas underweight (aOR 0.42; 95% CI, 0.18-0.97) was associated with lower odds of PCM. Factors associated with increased alpha angle included male sex (β coefficient, 2.99; 95% CI, 2.40-3.58), closed proximal femoral physis (β coefficient, 1.22; 95% CI, 0.61-1.82), cutting sport type (β coefficient, 1.07; 95% CI, 0.30-1.85), overweight (β coefficient, 0.89; 95% CI, 0.22-1.55), and obesity (β coefficient, 1.81; 95% CI, 0.57-3.04). Ethnicity and physical activity frequency were not associated with PCM or increased alpha angle. Conclusion: Among Dutch early adolescents, male sex and proximal femoral physis closure were associated factors of PCM and increased alpha angle, while cutting sport type, overweight, and obesity were modifiable factors of increased alpha angle. These findings could inform potential primary prevention strategies for PCM.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".