Cam morphology and the risk of developing radiographic hip osteoarthritis within 8 years: an individual participant data meta-analysis of 23 886 hips from the world COACH consortium

  • Jinchi Tang
  • , Fleur Boel
  • , Michiel Ma van Buuren
  • , Noortje S Riedstra
  • , Myrthe A van den Berg
  • , Harbeer Ahedi
  • , Nigel K Arden
  • , Sita M A Bierma-Zeinstra
  • , Cindy G Boer
  • , Flavia Cicutini
  • , Timothy Cootes
  • , Kay M Crossley
  • , David T Felson
  • , Willem-Paul Gielis
  • , Joshua J Heerey
  • , Graeme Jones
  • , Stefan Kluzek
  • , Nancy E Lane
  • , Claudia Lindner
  • , John A Lynch
  • Joyce van Meurs, Andrea Britt Mosler, Amanda E Nelson, Michael Nevitt, Edwin H G Oei, Jos Runhaar, Harrie Weinans, Rintje Agricola*
*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

OBJECTIVE: To assess the relationship between cam morphology and the development of radiographic hip osteoarthritis (RHOA), overall and in subgroups based on age, biological sex and body mass index (BMI).

METHODS: Hips with no RHOA at baseline and with available follow-up during 4-8 years were selected from the Worldwide Collaboration on Osteoarthritis PrediCtion for the Hip (World COACH) consortium. Alpha angles were uniformly measured on anteroposterior radiographs, with a threshold of 60° used to define cam morphology. Incident RHOA was defined as the transition from an RHOA-free state at baseline to definite diagnosis of RHOA at follow-up. The association between baseline cam morphology and the development of RHOA was assessed using a three-level mixed-effects logistic regression model, accounting for hip side, individual and cohort-level variation.

RESULTS: A total of 23 886 hips were included (mean age: 62.2±8.4 years; 70.6% female; BMI: 27.4±4.5; mean time to follow-up: 6.1±3.0 years). Cam morphology was associated with RHOA (OR: 1.87, 95% CI 1.36 to 2.59), as was a greater alpha angle (OR 1.02, 95% CI 1.01 to 1.03 for every degree increase). The overall relative risk of developing RHOA in hips with cam morphology was 1.62 (95%CI 1.26 to 2.07), greatest for those aged 51-60 years (2.15, 95% CI 1.55 to 2.98) and higher in males (2.50, 95% CI 1.67 to 3.73), compared with females (1.75,95% CI 1.24 to 2.48).

CONCLUSION: Hips with cam morphology have higher odds of developing RHOA within 4-8 years compared with hips without cam morphology. The relative risk was highest in subgroups of participants aged 51-60 years and in males, making cam morphology a potential target for primary or secondary prevention of RHOA.

Original languageEnglish
Article numberbjsports-2025-110144
Pages (from-to)28-35
JournalBritish Journal of Sports Medicine
Volume60
Early online date28 Nov 2025
DOIs
Publication statusPublished - 15 Jan 2026

Keywords

  • Cohort Studies
  • Hip
  • Osteoarthritis

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