Does the Type of Sport Influence Morphology of the Hip? A Systematic Review

Abstract

Background: Femoroacetabular impingement (FAI) has been extensively investigated and is strongly associated with athletic participation. Purpose: To assess (1) the prevalence of cam-type FAI across various sports; (2) whether kinematic variation among sports influences hip morphology; and (3) whether performance level, duration, and frequency of participation or other factors influence hip morphology in a sporting population. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic search of Embase, PubMed, and the Cochrane Library was undertaken following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Prospective and retrospective case series, case reports, and review articles published after 1999 were screened, and those that met the inclusion criteria decided a priori were included for analysis. Results: The literature search identified 58 relevant articles involving 5683 participants. A total of 49 articles described a higher prevalence of FAI across various “hip-heavy” sports, including soccer, basketball, baseball, ice hockey, skiing, golf, and ballet. In studies including nonathlete controls, a greater prevalence of FAI was reported in 66.7% of studies (n = 8/12). The highest alpha angle was identified at the 1-o’clock position (n = 9/9) in football, skiing, golf, ice hockey, and basketball. The maximum alpha angle was located in a more lateral position in goalkeepers versus positional players in ice hockey (1 vs 1:45 o’clock). A positive correlation was also identified between the alpha angle and both age and activity level (n = 5/8 and n = 2/3, respectively) and between prevalence of FAI and both age and activity level (n = 2/2 and n = 4/5). Conclusion: Hip-heavy sports show an increased prevalence of FAI, with specific sporting activities influencing hip morphology. There is some evidence to suggest that a longer duration and higher level of training also result in an increased prevalence of FAI. Registration: CRD4202018001 (PROSPERO).

Basketball Players Undergoing Primary Hip Arthroscopy Exhibit Higher Grades of Acetabular Cartilage Damage but Achieve Favorable Midterm Outcomes and Return to Sports Rates Comparable With a Propensity-Matched Group of Other Cutting Sports Athletes

“…Patients who did not improve after 3 months of nonoperative treatment were recommended for surgery by the senior author. 10,30…”

Instrumental Diagnosis and Preoperative Planning of Hip Arthroscopy in Femoroacetabular Impingement Syndrome: Lecture

“…Деформация внутрисуставного отдела бедренной кости, приводящая к импинджменту и названная cam-деформацией (от англ. cam -кулак), является чаще всего следствием перенесенных в детском возрасте заболеваний, таких как эпифизиолиз головки бедренной кости, болезнь Легга -Кельве -Пертеса или может быть следствием полученных травм, развившихся посттравматических деформаций или изменений в результате постоянных избыточных нагрузок [19,20].…”

Oxford consensus on primary cam morphology and femoroacetabular impingement syndrome: part 1—definitions, terminology, taxonomy and imaging outcomes

“…Although PCM is mostly an inconsequential bony prominence that develops at the femoral head-neck junction of the hip, it is highly prevalent in many athlete populations. [1][2][3] In those few athletes for whom it is not benign, the resulting hip osteoarthritis can be debilitating. 4 This predominantly benign morphology thus places existing and potential athletepatients at risk of future hip disease.…”

“…Therefore, we have included a broader range of outcomes in our use of the term natural history in this study. A preliminary concept analysis we recently published, 5 identified four key areas for further attention: it (1) proposed a new conceptual definition for the morphology based on five defining attributes; (2) spotlighted inconsistent and troublesome terminology, while also commending the important Warwick Agreement from a small and selective expert panel 7 ; (3) introduced taxonomy distinguishing between primary and secondary cam morphology; and (4) exposed the challenges of operationalising the hip morphology.…”