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Title: Femoroacetabular impingement and cam morphology : contributions to bioarchaeology and forensic anthropology
Author: Saunders, Emma Louise
ISNI:       0000 0004 9354 5463
Awarding Body: Cranfield University
Current Institution: Cranfield University
Date of Award: 2020
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Femoroacetabular impingement is a clinical disorder of the hip caused by premature contact between the femur and the acetabulum. A lead cause of this condition is cam morphology, additional bone growth on the anterior aspect of the femoral head. Cam morphology has been associated with physical activity due to its high prevalence rates in athletes compared to non-athletes. A link between non-metric traits of the femur, particularly; Poirier’s facets, plaque and cribra, and cam morphology has been suggested due to their shared location and suggested aetiology. Osteitis pubis, an overuse syndrome of the pubic symphysis, is believed to be a compensatory injury of femoroacetabular impingement. The overall aim of this study was to determine the contributions of femoroacetabular impingement to the disciplines of bioarchaeology and forensic anthropology, with regards to femoral non-metric traits analysis, activity reconstruction and awareness of conditions that may affect the formation of biological profiles. To achieve this, this study aimed to establish if there is a link between cam morphology and non-metric traits of the anterior aspect of the femur. This would provide further understanding of the respective/joint aetiologies through the use of multidisciplinary literature. It also aimed to determine if the development of cam morphology is linked to occupational physical activity. Additionally, this study looked to determine if any osseous changes are present in individuals with femoroacetabular impingement in association with cam morphology, to allow the identification of symptomatic individuals when the presence of clinical information is not available. Finally, it also aimed to determine if there is a link between cam morphology and osteitis pubis at the pubic symphysis. This would contribute to both bioarchaeology and forensic anthropology, by highlighting a condition which may impact an area commonly used for the age estimation. Two skeletal collections, the Wharram Percy collection and the Luís Lopes Identified Skeletal Collection, and a clinical comparison sample were utilised. These collections were selected due to presence of contextual information regarding lifestyle and occupation in different forms. The clinical comparison sample consisted of 3D volume ii rendered CT models of individuals being investigated for femoroacetabular impingement and a control sample. Non-metric traits of the femur and commonly used clinical measures to determine the presence of cam morphology were recorded on all samples. Recording criteria for osteitis pubis was developed and applied to the pubic symphysis of the two skeletal collections. Comparisons of these measurements were made within and between the samples. The results of this study have shown there is a link between Poirier’s facets and plaque with cam morphology. Through the use of contextual information, it is recommended this association is a functional adaptation. There was no association between cam morphology, alpha angle size and occupational physical activity groups in adults. It is suggested cam morphology is therefore a better indicator of activity levels, or other extrinsic factors, requiring additional stability at the hip during skeletal maturation. No clear osseous indicators of the presence of FAI due to cam morphology were identified. Therefore, it is not possible to identify symptomatic individuals through skeletal changes alone. There was also limited evidence of a link between osteitis pubis traits and alpha angle size. Although eburnation could be an indicator for the later stages of this condition, however, there is the requirement for further study to confirm this.
Supervisor: Marquez-Grant, Nicholas ; Zioupos, Peter Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available