Young elite Alpine and Mogul skiers have a higher prevalence of cam morphology than non-athletes

Aminoff, Anna Swärd; Agnvall, Cecilia; Todd, Carl; Jonasson, Peter; Thoreson, Olof; Sansone, Mikael; Swärd, Leif; Karlsson, Jón; Baranto, Adad

doi:10.1007/s00167-018-5236-4

Cited by 14 publications

(18 citation statements)

References 49 publications

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“…Alpine skiing predisposes the hip to greater loads due to the constant shift in hip and knee position from extension to almost maximal flexion during a ski run, particularly on hard and uneven snow surfaces. 40 Abnormal bony prominence of either the femoral head-neck junction or acetabular margin predisposes to premature contact between these two structures during repetitive hip flexion and internal rotation, leading to anterosuperior chondral and labral damage. 41 There is increased prevalence of FAI in skiers compared with nonskiers, although it is still more common in other sports such as soccer, track and field, ice hockey, and basketball.…”

Section: Hip and Thighmentioning

confidence: 99%

“…41 There is increased prevalence of FAI in skiers compared with nonskiers, although it is still more common in other sports such as soccer, track and field, ice hockey, and basketball. 40,41 The frequency of cam-type morphology in elite skiers is between 42% and 49%, with males outnumbering females. 40 Overuse hip injuries also occur but are typically due to training rather than skiing itself.…”

Section: Hip and Thighmentioning

confidence: 99%

“…40,41 The frequency of cam-type morphology in elite skiers is between 42% and 49%, with males outnumbering females. 40 Overuse hip injuries also occur but are typically due to training rather than skiing itself. 42 Trochanteric bursitis and stress fractures are the most common diagnoses.…”

Section: Hip and Thighmentioning

confidence: 99%

See 2 more Smart Citations

Imaging Review of Alpine Ski Injuries

Flores

Murray

Bohyn

et al. 2022

Semin Musculoskelet Radiol

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Skiing is a continuously evolving winter sport, responsible for a considerable number of musculoskeletal injuries. Specific injury patterns and mechanisms in the upper and lower extremities, head, and spine are influenced by skier expertise and skill, position during injury, and environmental conditions. Predilection for certain joints and injury patterns have changed over time, largely due to technological advancements in equipment, increased awareness campaigns, and preventive protocols. Knowledge and understanding of these trends and developments can aid the radiologist to reach a timely and accurate diagnosis, thereby guiding clinical management and potentially reducing the overall incidence of debilitation and death.

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Section: Hip and Thighmentioning

confidence: 99%

Section: Hip and Thighmentioning

confidence: 99%

See 1 more Smart Citation

Imaging Review of Alpine Ski Injuries

Flores

Murray

Bohyn

et al. 2022

Semin Musculoskelet Radiol

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“…Athletes have a higher prevalence of cam morphology compared with general populations (48-79% vs. 5-55%) [14]. The prevalence of cam morphology in Alpine and Mogul skiers has been reported to be between 42 and 49% [15,16]. Emerging evidence suggests a growing trend from high, repeated axial loading of the hip joints during skeletal maturation may be a risk factor for the development of cam morphology [17][18][19][20].…”

Section: Introductionmentioning

confidence: 99%

Hip pain and its correlation with cam morphology in young skiers—a minimum of 5 years follow-up

Abrahamson¹,

Jonasson²,

Sansone³

et al. 2020

J Orthop Surg Res

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Background There is conflicting evidence regarding the association between cam morphological changes and hip pain, and it remains unclear who with cam morphology will develop hip pain and who will not. This study aimed to investigate the correlation between cam morphology, hip pain, and activity level at a 5-year follow-up in young Alpine and Mogul skiers. Method All students (n = 76) at Åre Ski National Sports High School were invited and accepted participation in this prospective study at baseline. Magnetic resonance imaging (MRI) of both hips was conducted to evaluate the presence of cam morphology (α-angle ≥ 55°) and its size alongside the reporting of hip pain, type, and frequency of training by the Back and hip questionnaire, at baseline. After 5 years, the skiers were invited to complete a shortened version of the same questionnaire. Results A total of 60 skiers (80%) completed the follow-up questionnaire, of which 53 had concomitant MRI data. Cam morphology was present in 25 skiers (47.2%, 39 hips). Hip pain at baseline and at follow-up was reported in 17 (28.3%) and 22 (36.7%) skiers, respectively. No correlations were found between the activity level, the frequency, and the size of cam morphology and hip pain, except for the right hip α-angle at 1 o’clock and hip pain in skiers with cam morphology at baseline (rs = 0.49; P = 0.03) and at follow-up (rs = 0.47; P = 0.04). A total of 73.3% skiers had retired, of which 48% reported this was due to injuries. Conclusion Hip pain was not shown to be correlated, or had a low correlation, with activity level and the presence and size of cam morphology in young skiers on a 5-year follow-up. Based on these results, cam morphology or activity level did not affect hip pain to develop during 5 years of follow-up in young skiers. Furthermore, this study highlights that almost 75% of young elite skiers had retired from their elite career with almost 50% reporting that this was due to injuries sustained from skiing.

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“…4,17,34 Elite skiers have been identified as having a higher prevalence of cam morphology than nonathletes. 3 Additionally, snowboarding and skiing, including alpine, mogul, and freestyle, expose the lower extremities to significantly increased force magnitudes at high speeds, often in vulnerable positions. 18,20,21 The relationship between the trunk and hips can change rapidly from deep flexion to full extension several times over the course of a ski or snowboard run, which is frequently on uneven terrain involving jumps and landings on hardpack snow or ice.…”

mentioning

confidence: 99%

Femoroacetabular Impingement in Elite Skiers and Snowboarders: Return to Sports and Outcomes After Hip Arthroscopy

et al. 2022

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Background: Hip arthroscopy has been shown to be an effective treatment for femoroacetabular impingement (FAI) in high–level athletes; however, limited outcome and return–to–play data exist for hip arthroscopy in skiers and snowboarders. Purposes: To determine the return–to–sports rate of elite skiers and snowboarders who have undergone hip arthroscopic surgery for FAI and to assess hip–related outcomes at a minimum 2–year follow–up. Study Design: Case series; Level of evidence, 4. Methods: Elite skiers and snowboarders who underwent hip arthroscopy for the treatment of FAI between 2005 and 2018 were identified via a retrospective review of prospectively collected data. Data were obtained from fis-ski.org , usskiandsnowboard.org , xgames.com , and wikipedia.org , including information on each player's career length, participation on a national team, and time between surgery and first competition after surgery. Patient-reported outcomes (PROs) were prospectively collected preoperatively and at minimum 2 years postoperatively. Results: In total, 26 elite skiers and snowboarders (34 hips) were included. The mean ± standard deviation age at surgery was 24.5 ± 6.7 years (range, 18.7-46.8 years). A total of 85% (22/26) returned to elite–level competition at 8.9 months (range, 2.9-23.7 months) with an average career length of 3.6 ± 2.7 years after surgery. Four athletes (5 hips) required revision arthroscopy, with adhesions being the most frequent indication. At a mean follow–up of 7.7 ± 3.2 years, significant improvement in PROs ( P < .05) was demonstrated for the Hip Outcome Score (HOS)–Activities of Daily Living (from 76 ± 20 to 95 ± 6), HOS–Sport Specific Subscale (from 63 ± 28 to 92 ± 14), modified Harris Hip Score (from 70 ± 19 to 89 ± 12), and 12-Item Short Form Health Survey Physical Component Summary (from 45 ± 11 to 54 ± 8). Patient satisfaction had a mean of 8 ± 2 (range, 1-10) and median of 10. Conclusion: The return–to–competition rate in elite skiers and snowboarders after hip arthroscopy for FAI was 85% at an average of 8.9 months and with a career length of 3.6 years after surgery. Significant improvement in PROs was demonstrated for the HOS–Activities of Daily Living, HOS–Sport Specific Subscale, modified Harris Hip Score, and 12-Item Short Form Health Survey Physical Component Summary, with a median patient satisfaction score of 10. These findings support hip arthroscopy as an effective procedure for the treatment of FAI in elite skiers and snowboarders with symptomatic activity–limiting hip pain, allowing them to return to their previous levels of competition at a high rate.

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Young elite Alpine and Mogul skiers have a higher prevalence of cam morphology than non-athletes

Cited by 14 publications

References 49 publications

Imaging Review of Alpine Ski Injuries

Imaging Review of Alpine Ski Injuries

Hip pain and its correlation with cam morphology in young skiers—a minimum of 5 years follow-up

Femoroacetabular Impingement in Elite Skiers and Snowboarders: Return to Sports and Outcomes After Hip Arthroscopy

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