PDF(Pubmed)
Abstract：
BACKGROUND: Primary cam morphology is a mostly benign bony prominence that develops at the femoral head-neck junction of the hip, but it is highly prevalent in many athlete populations. In the small proportion of athletes for whom it is not benign, the resulting hip osteoarthritis can be debilitating. Clinicians, athletes, patients and researchers do not yet agree on important primary cam morphology elements. We aimed to ascertain and improve the level of agreement on primary cam morphology definitions, terminology, taxonomy and imaging outcome measures.
METHODS: To collect and aggregate informed opinions, an expert panel-the Young Athlete\'s Hip Research Collaborative-rated primary cam morphology definition, terminology, taxonomy and imaging outcome statements through an online Delphi exercise followed by an online meeting to explore areas of tension and dissent. Reporting followed Conducting and REporting DElphi Studies.
RESULTS: A diverse and inclusive Delphi panel (n=65 for rounds 1 and 2, representing 18 countries; 6 stakeholder groups; 40% women) agreed on 35 of 47 statements in 4 domains, while surfacing areas of tension and dissent. This Delphi panel agreed on four key issues essential to moving research and clinical care forward around primary cam morphology. They agreed on: (1) definition, confirming its conceptual attributes (tissue type, size, location, shape and ownership); (2) terminology-use \'morphology\' and not terms with a negative connotation like \'lesion\', \'abnormality\' or \'deformity\'; (3) taxonomy, distinguishing between primary and secondary cam morphology, and (4) imaging outcomes, a continuous bone/cartilage alpha angle on radial femoral head-neck MRI for primary cam morphology aetiology research.
CONCLUSIONS: This consensus provides athletes, patients, clinicians and researchers with a strong foundation to guide more precise communication, better clinical decision-making and higher value research about primary cam morphology and its natural history.
METHODS: To collect and aggregate informed opinions, an expert panel-the Young Athlete\'s Hip Research Collaborative-rated primary cam morphology definition, terminology, taxonomy and imaging outcome statements through an online Delphi exercise followed by an online meeting to explore areas of tension and dissent. Reporting followed Conducting and REporting DElphi Studies.
RESULTS: A diverse and inclusive Delphi panel (n=65 for rounds 1 and 2, representing 18 countries; 6 stakeholder groups; 40% women) agreed on 35 of 47 statements in 4 domains, while surfacing areas of tension and dissent. This Delphi panel agreed on four key issues essential to moving research and clinical care forward around primary cam morphology. They agreed on: (1) definition, confirming its conceptual attributes (tissue type, size, location, shape and ownership); (2) terminology-use \'morphology\' and not terms with a negative connotation like \'lesion\', \'abnormality\' or \'deformity\'; (3) taxonomy, distinguishing between primary and secondary cam morphology, and (4) imaging outcomes, a continuous bone/cartilage alpha angle on radial femoral head-neck MRI for primary cam morphology aetiology research.
CONCLUSIONS: This consensus provides athletes, patients, clinicians and researchers with a strong foundation to guide more precise communication, better clinical decision-making and higher value research about primary cam morphology and its natural history.
摘要：
背景：初级凸轮形态是在髋关节的股骨头-颈交界处发展的良性骨性突出，但它在许多运动员人群中非常普遍。在一小部分运动员中，这对他们来说不是良性的，由此产生的髋部骨关节炎可能使人衰弱。临床医生,运动员,患者和研究人员尚未就重要的主要凸轮形态元素达成共识。我们旨在确定和提高主要凸轮形态定义的一致性水平，术语,分类学和成像结果测量。
方法：要收集和汇总知情意见，专家小组-青年运动员髋关节研究协作评级的主要凸轮形态定义，术语,通过在线Delphi练习进行分类学和成像结果陈述，然后进行在线会议，以探讨紧张和异议的领域。报告是在进行和恢复DElphi研究之后进行的。
结果：一个多元化和包容性的Delphi小组（第1轮和第2轮n=65，代表18个国家；6个利益相关者团体；40％的妇女）在4个领域的47项声明中的35项达成一致，同时出现紧张和异议的地区。此Delphi小组就围绕主要凸轮形态推进研究和临床护理所必需的四个关键问题达成了共识。他们同意：（1）定义，确认其概念属性(组织类型，尺寸,location,形状和所有权)；(2)术语-使用“形态”，而不是具有负面含义的术语，如“病变”，“异常”或“畸形”；(3)分类法，区分初级和次级凸轮形态，和(4)成像结果，桡骨股骨颈MRI上连续的骨/软骨α角用于主要凸轮形态病因研究。
结论：这一共识为运动员提供了，病人,临床医生和研究人员有坚实的基础来指导更精确的沟通，关于初级凸轮形态及其自然史的更好的临床决策和更高的价值研究。
方法：要收集和汇总知情意见，专家小组-青年运动员髋关节研究协作评级的主要凸轮形态定义，术语,通过在线Delphi练习进行分类学和成像结果陈述，然后进行在线会议，以探讨紧张和异议的领域。报告是在进行和恢复DElphi研究之后进行的。
结果：一个多元化和包容性的Delphi小组（第1轮和第2轮n=65，代表18个国家；6个利益相关者团体；40％的妇女）在4个领域的47项声明中的35项达成一致，同时出现紧张和异议的地区。此Delphi小组就围绕主要凸轮形态推进研究和临床护理所必需的四个关键问题达成了共识。他们同意：（1）定义，确认其概念属性(组织类型，尺寸,location,形状和所有权)；(2)术语-使用“形态”，而不是具有负面含义的术语，如“病变”，“异常”或“畸形”；(3)分类法，区分初级和次级凸轮形态，和(4)成像结果，桡骨股骨颈MRI上连续的骨/软骨α角用于主要凸轮形态病因研究。
结论：这一共识为运动员提供了，病人,临床医生和研究人员有坚实的基础来指导更精确的沟通，关于初级凸轮形态及其自然史的更好的临床决策和更高的价值研究。
