Ray Liu: Ancient Bones, Slipped Capital Femoral Epiphysis & the Cam deformity

This week, I speak with Raymond Liu, a pediatric orthopedic surgeon at University Hospitals, Rainbow Babies & Children’s Hospital, and the Victor M. Goldberg Endowed Chair in Orthopaedics.  He is a world-renowned expert on complex hip pathology and has published extensive research focusing on sophisticated analysis of different osteological collections. We begin by discussing slipped capital femoral epiphysis (SCFE) and its association with athletic activity, Challenging the notion that this condition is less frequent in children involved in athletic activities. We then examine the similarities and, more importantly, the big differences between the so-called primary Cam morphology of the proximal femur and SCFE. He explains a paper comparing similarities in the proximal femoral anatomy between 3 distinct historical populations: a Neolithic population from the Middle East, a medieval population from Eastern Europe, and a more recent aboriginal population from Australia. We talk about the spinopelvic relationship and its relation to the development of Cam morphology. We discuss the epiphyseal tubercle, which he has described elegantly and signaled its importance, the distinction between stable and unstable slips, and its relationship to the blood vessels that supply the femoral head. We also consider his current and future research endeavors, amongst other things.