Comparative study of the femoroacetabular impingement (FAI) prevalence in male semiprofessional and amateur soccer players

Lahner, Matthias; Walter, Philipp Alexander; Pellengahr, Christoph von Schulze; Hagen, Marco; Engelhardt, Lars Victor von; Lukas, Carsten

doi:10.1007/s00402-014-2008-6

Cited by 50 publications

(54 citation statements)

References 35 publications

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“…Preventative physiotherapy-led rehabilitation and conditioning strategies may be appropriate in professional athletes where the prevalence of cam morphology is high, such as professional football teams 77. In exceptional circumstances, and in a shared decision-making process with a patient, surgery may occasionally be appropriate for high-risk patients.…”

Section: Discussionmentioning

confidence: 99%

The Warwick Agreement on femoroacetabular impingement syndrome (FAI syndrome): an international consensus statement

et al. 2016

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The 2016 Warwick Agreement on femoroacetabular impingement (FAI) syndrome was convened to build an international, multidisciplinary consensus on the diagnosis and management of patients with FAI syndrome. 22 panel members and 1 patient from 9 countries and 5 different specialties participated in a 1-day consensus meeting on 29 June 2016. Prior to the meeting, 6 questions were agreed on, and recent relevant systematic reviews and seminal literature were circulated. Panel members gave presentations on the topics of the agreed questions at Sports Hip 2016, an open meeting held in the UK on 27-29 June. Presentations were followed by open discussion. At the 1-day consensus meeting, panel members developed statements in response to each question through open discussion; members then scored their level of agreement with each response on a scale of 0-10. Substantial agreement (range 9.5-10) was reached for each of the 6 consensus questions, and the associated terminology was agreed on. The term 'femoroacetabular impingement syndrome' was introduced to reflect the central role of patients' symptoms in the disorder. To reach a diagnosis, patients should have appropriate symptoms, positive clinical signs and imaging findings. Suitable treatments are conservative care, rehabilitation, and arthroscopic or open surgery. Current understanding of prognosis and topics for future research were discussed. The 2016 Warwick Agreement on FAI syndrome is an international multidisciplinary agreement on the diagnosis, treatment principles and key terminology relating to FAI syndrome.

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Section: Discussionmentioning

confidence: 99%

The Warwick Agreement on femoroacetabular impingement syndrome (FAI syndrome): an international consensus statement

et al. 2016

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“…In the anterosuperior portion of the femoral head neck junction (1–3 o'clock), where cam morphology is most frequently identified,26 median α angles were higher in the trail hips (66 ° , 56 ° and 45 ° vs 62 ° , 51 ° and 41 ° ) reaching statistical significance at 2 and 3 o'clock. Other studies assessing hip morphology in athletes have not demonstrated differences in head neck offset between hips 7 28 29 34–37. In the general population, Hack et al measured α angles in the hips of 200 volunteers.…”

Section: Discussionmentioning

confidence: 95%

“…Therefore, two separate definitions were used with results of each definition reported independently to allow comparisons: A hip with an α angle >55 ° at 3 o'clock 24 28 29

A hip with an α angle >83 ° at any position around the femoral neck 30

…”

Section: Methodsmentioning

confidence: 99%

Hip morphology in elite golfers: asymmetry between lead and trail hips

et al. 2016

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AimDuring a golf swing, the lead hip (left hip in a right-handed player) rotates rapidly from external to internal rotation, while the opposite occurs in the trail hip. This study assessed the morphology and pathology of golfers’ hips comparing lead and trail hips.MethodsA cohort of elite golfers were invited to undergo MRI of their hips. Hip morphology was evaluated by measuring acetabular depth (pincer shape=negative measure), femoral neck antetorsion (retrotorsion=negative measure) and α angles (cam morphology defined as α angle >55° anteriorly) around the axis of the femoral neck. Consultant musculoskeletal radiologists determined the presence of intra-articular pathology.Results55 players (mean age 28 years, 52 left hip lead) underwent MRI. No player had pincer morphology, 2 (3.6%) had femoral retrotorsion and 9 (16%) had cam morphology. 7 trail hips and 2 lead hips had cam morphology (p=0.026). Lead hip femoral neck antetorsion was 16.7° compared with 13.0° in the trail hip (p<0.001). The α angles around the femoral neck were significantly lower in the lead compared with trail hips (p<0.001), with the greatest difference noted in the anterosuperior portion of the head neck junction; 53° vs 58° (p<0.001) and 43° vs 47° (p<0.001). 37% of trail and 16% of lead hips (p=0.038) had labral tears.ConclusionsGolfers’ lead and trail hips have different morphology. This is the first time side-to-side asymmetry of cam prevalence has been reported. The trail hip exhibited a higher prevalence of labral tears.

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“…The findings in the study differ with those reported previously in semi-professional soccer players, where some players had unilateral cam morphology. 15 This suggests that within AF players, differences between cam morphology on the kicking and non-kicking leg are less common. These differences may be due to the variations in training load with differences in the proportion of kicking on the dominant and nondominant legs during adolescence.…”

Section: Discussionmentioning

confidence: 99%

“…11 The prevalence appears to be specifically high in athletic groups, with cam morphologies evident in 72% of collegiate football players, 12 68% of elite soccer players 13 and 75% of youth ice hockey players 14 however to date no studies have explored the prevalence of these radiological findings within an AF population. It has also been shown within semi-professional soccer players that the presence of cam morphology differs between the kicking and non-kicking legs 15 however this has yet to be investigated in AF. Finally the prevalence of cam morphology also appears to be significantly related to ethnic backgrounds with white soccer players having a higher proportion of large cam morphology compared to their black counterparts.…”

Section: Introductionmentioning

confidence: 99%

Clinical Measures of Hip Range of Motion Do Not Correlate With the Degree of Cam Morphology in Semi-Elite Australian Footballers: A Cross-Sectional Study

Murphy

Kemp

Smith

et al. 2017

Intl J Sports Phys Ther

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Background: Clinical testing to determine the presence of a cam morphology is becoming more common however the correlation between hip range of motion and the degree of cam morphology remains controversial in the literature. The prevalence of a cam morphology in athletes has been reported as higher than in the general population but the prevalence of cam morphology has not been reported in Australian Football (AF). Purpose:The purpose of this study was to determine the correlation between hip range of motion and hip alpha angle and report the proportion of players with a cam morphology in a sample of AF players.Design: Cross-sectional Study.Methods: Twenty-one semi-elite AF players (42 hips) from the Peel Thunder Football Club were included in this study. A hip Flexion Internal Rotation (IR) test and a modified maximal squat test using the difference in depth of squat in hip internal and external rotation were used. These measures were then compared to alpha angles on 90 degree Dunn view x-rays.Results: Four of the 42 hips (9.5%) had a cam morphology (alpha angle >60 degrees). There was no significant correlation between alpha angle and ROM in a Flexion IR test or the difference in modified maximal squat test depth within this sample of players. Conclusions:The proportion of cam morphology seems to be lower in this sample than the previously reported prevalence in other sports. The lack of correlations between hip range and hip alpha angle in players means that screening hips using clinical measures to detect cam morphology associated with poor hip range of motion may be inaccurate. Level of Evidence: Level 3a

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Comparative study of the femoroacetabular impingement (FAI) prevalence in male semiprofessional and amateur soccer players

Abstract: Semiprofessional players have a higher prevalence of an increased α angle in the kicking leg than the amateur group at the same age. The kicking leg is predisposed for FAI.

Cited by 50 publications

References 35 publications

The Warwick Agreement on femoroacetabular impingement syndrome (FAI syndrome): an international consensus statement

The Warwick Agreement on femoroacetabular impingement syndrome (FAI syndrome): an international consensus statement

Hip morphology in elite golfers: asymmetry between lead and trail hips

Clinical Measures of Hip Range of Motion Do Not Correlate With the Degree of Cam Morphology in Semi-Elite Australian Footballers: A Cross-Sectional Study

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