The Prevalence of Radiographic Hip Abnormalities in Elite Soccer Players

Gerhardt, Michael B.; Romero, Alex; Silvers, Holly J.; Harris, David; Watanabe, Diane; Mandelbaum, Bert R.

doi:10.1177/0363546511432711

Cited by 204 publications

(186 citation statements)

References 30 publications

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“…Many studies have investigated the associations between sex and hip anatomy (Table 5) [5,9,17,29,37,46,52] and between the femoral and acetabular parameters measured in this study (Table 6) [1-3, 9, 14, 24, 31, 39, 46, 50, 52, 54]. Our findings agree with most of this literature but do conflict with two studies [2,54] that found no association between femoral and acetabular version (Table 6).…”

Section: Discussionsupporting

confidence: 77%

“…For example, symptomatic dysplasia and excessive femoral anteversion are more common in females [18,20,35,49,54]. In several series of patients with FAI, women with symptomatic impingement had smaller cam deformities [17,20,24,37] but could present with worse preoperative scores for pain and function than men [23]. The associations between these various anatomic factors and how often they occur in a painful hip are unclear but if unaddressed at the time of surgery might explain failed hip preservation surgery.…”

Section: Introductionmentioning

confidence: 99%

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Two or More Impingement and/or Instability Deformities Are Often Present in Patients With Hip Pain

Tibor¹,

Liebert

Sutter

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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Background Damage to the hip can occur due to impingement or instability caused by anatomic factors such as femoral and acetabular version, neck-shaft angle, alpha angle, and lateral center-edge angle (CEA). The associations between these anatomic factors and how often they occur in a painful hip are unclear but if unaddressed might explain failed hip preservation surgery. Questions/purposes We determined (1) the influence of sex on the expression of impingement-related or instability-related factors, (2) the associations among these factors, and (3) how often both impingement and/or instability factors occur in the same hip.Methods We retrospectively reviewed a cohort of 170 hips (145 patients) undergoing MR arthrography of the hip for any reason. We excluded 58 hips with high-grade dysplasia, Perthes' sequelae, previous surgery, or incomplete radiographic information, leaving 112 hips (96 patients). We measured femoral version and alpha angles on MR arthrograms. Acetabular anteversion, lateral CEA, and neck-shaft angle were measured on pelvic radiographs. Results We observed a correlation between sex and alpha angle. Weak or no correlations were observed between the other five parameters. In 66% of hips, two or more (of five) impingement parameters, and in 51% of hips, two or more (of five) instability parameters were found. Conclusions Patients with hip pain frequently have several anatomic factors potentially contributing to chondrolabral damage. To address pathologic hip loading due to impingement and/or instability, all of the anatomic influences should be known. As we found no associations between anatomic factors, we recommend an individualized assessment of each painful hip. Level of Evidence Level III, prognostic study. See Instructions for Authors for a complete description of levels of evidence.

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Section: Discussionsupporting

confidence: 77%

Section: Introductionmentioning

confidence: 99%

Two or More Impingement and/or Instability Deformities Are Often Present in Patients With Hip Pain

Tibor¹,

Liebert

Sutter

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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“…This has led to increased interest in the early diagnosis of FAI via potential screening, especially in patients who are considered to be at high risk, such as elite athletes [10], athletes who participate in sports that have higher risks for changes in morphologic features of the hip [16,24], and siblings of patients with impingement [30]. Abnormalities of morphologic features that can lead to FAI include cam abnormality on the femoral side and/or pincer overcoverage on the acetabular side [15,33].…”

Section: Introductionmentioning

confidence: 99%

Does Femoral Rotation Influence Anteroposterior Alpha Angle, Lateral Center-edge Angle, and Medial Proximal Femoral Angle? A Pilot Study

Monazzam

Bomar

Agashe

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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Background Femoral rotation on AP radiographs affects several parameters used to assess morphologic features of the proximal femur but its effect on femoroacetabular impingement parameters remains unknown. Question/purposes We therefore evaluated and characterized the potential effect of femoral rotation on (1) AP alpha angle, (2) lateral-center edge angle (LCEA), and (3) medial proximal femoral angle (MPFA) on AP hip radiographs. Methods We took seven AP hip radiographs at intervals of successive femoral rotation on a single dry, cadaveric specimen: 60°, 40°, and 20°internal rotation; 0°neutral/ anatomic rotation; and 20°, 40°, and 50°external rotation. The AP alpha angle, LCEA, and MPFA were measured on all radiographs by two independent evaluators.Results Within the range of femoral rotation studied, the AP alpha angle ranged from 39°to 62°, the LCEA from 25°to 35°, and the MPFA from 70°to 115°. MPFA and AP alpha angle showed a linear relationship with femoral rotation. Each additional degree of internal rotation produced a reciprocal reduction of the MPFA by 0.36°and the AP alpha angle by 0.18°and vice versa in external rotation. The LCEA, especially within the internal rotation range, showed minimal variation. Conclusions These changes in radiographic parameters emphasize the importance of femoral rotation and patient positioning. We recommend radiographs be evaluated for excessive femoral rotation or nonstandardized positioning before interpretation for diagnostic and treatment implications. It may be prudent to repeat radiographs in these circumstances or, when standardized positioning is not feasible, proceed toward advance imaging.

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“…Zudem war bei 50 % (Frauen) bzw. 72 % (Männer) der in einer weiteren Studie untersuchten Profifußballer radiologisch eine Impingementdeformität nachzuweisen [9].…”

Section: Klinische Untersuchungunclassified