Finite element analysis of the proximal femoral growth plate biomechanics: insights into cam deformity risk of adolescent athletes.

Objectives: To investigate the biomechanical influences on the morphology and development of the proximal femur by analyzing the stress distribution within the proximal femoral epiphyseal growth plate (EGP) of adolescents during both daily activities and sports. Methods: Three-dimensional pelvic CT data from adolescents were employed to construct a finite element mechanical analysis (FEMA) model of the hip joint. Real-time, continuous data on hip forces and angles were collected during daily activities and sports using a gait and joint mechanics acquisition system. Representative mechanical loads of the femur and hip joint were selected from the collected data as loading conditions. A three-dimensional FEMA of the hip joint under these conditions was performed to evaluate stress distribution across the growth plate and its nine distinct zones. Results: Compared with daily activities, basketball dribbling and layups, as well as football shooting and passing, resulted in higher concentrations of compressive stress within the lateral region of the growth plate, whereas ice hockey demonstrated greater compressive stress in the central regions, extending laterally. Basketball layups exhibited concentrated shear stress within the medial and central regions. Football dribbling and passing showed increased shear stress in the medial regions, while ice hockey exhibited a concentration of shear stress in the medial regions. Conclusion: High-impact sports produce concentrated lateral compressive stress and medial shear stress on the growth plate, forming mechanical stimuli distinct from daily activities. These differential stress distributions provide a reference for exploring mechanical features associated with adolescent hip morphological variation.