Prevalence of FAI radiographic hip abnormalities in elite soccer players: are there differences related to skeletal maturity?

Abstract

BackgroundFemoroacetabular impingement (FAI) can be a source of hip pain in young adults. Some reports have revealed that participation in high-impact sports may play a role in the development of cam deformity, and there is a higher prevalence of signs of cam impingement in asymptomatic adolescents who participate in soccer and basketball than in non-athlete controls; however, current evidence is scarce regarding the initiation and development of deformities.PurposeThe aim of this study was to evaluate the prevalence of radiographic hip abnormalities related to FAI in young elite soccer players and compare this with findings in a group of adult elite soccer players.Subjects and methodsAnteroposterior pelvic and cross-table hip radiographs were obtained for 75 young elite soccer players with skeletal immaturity (group 1) and for 75 adult elite soccer players (group 2), all of whom were previously asymptomatic and had no history of hip disease. After exclusion, group 1 included 72 patients, and group 2 included 70 patients. Radiological signs of FAI were evaluated.Results34 subjects in groups 1 and 2 demonstrated cam morphology. The prevalence of pincer morphology was 30 in group 1 and 36 in group 2. However, these differences were not statistically significant.ConclusionWe found no differences in the prevalence of FAI radiological signs between soccer players in their late adolescence and adult soccer players.

Etiology and Pathomechanics of Femoroacetabular Impingement

“…Johnson et al likewise showed no difference in prevalence of cam lesions among elite soccer players [49]. When comparing skeletally immature soccer players to adult players, there was no difference in cam morphology prevalence [50]. A recent study found a 4°increase in alpha angles in English youth soccer players compared to non-athletic controls and 7.7°g reater alpha angles in players competing at a national or international level [51].…”

How does the cam morphology develop in athletes? A systematic review and meta-analysis

“…Eight studies reported alpha angles in open and closed physis cohorts 16,29,32,33,35,36,38,39 . Two of these studies reported alpha angle in lateral radiographic views 29,32 , no studies reported alpha angle in AP radiographic view, and the remainder measured alpha angle in MRI images.…”

“…Eight studies reported alpha angles in open and closed physis cohorts 16,29,32,33,35,36,38,39 . Two of these studies reported alpha angle in lateral radiographic views 29,32 , no studies reported alpha angle in AP radiographic view, and the remainder measured alpha angle in MRI images. Six were considered appropriate for primary meta-analysis of the anterosuperior femoral neck 29,32,35,36,38,39 Five studies reported alpha angle in individual radial planes 16,33,35,36,38…”

“…Five studies reported cam prevalence in open and closed physis cohorts 15,29,32,36,39 . Three reported PPH 15,36,39 , and two PPI 29,32 .…”

“…Five studies reported cam prevalence in open and closed physis cohorts 15,29,32,36,39 . Three reported PPH 15,36,39 , and two PPI 29,32 . Meta-analyses were inconclusive regarding the association between physeal closure and PPH (OR 5.37; 95% CI 0.97, 29.65; I 2 86%), whilst meaningful analysis was not possible with PPI data.…”