Top

Knee Surgery, Sports Traumatology, Arthroscopy

Published in:

01-04-2014 | Hip

Femoroacetabular impingement in elite ice hockey players

Authors: Olufemi R. Ayeni, Kamal Banga, Mohit Bhandari, Zeev Maizlin, Darren de SA, Dmitry Golev, Srinivasan Harish, Forough Farrokhyar

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 4/2014

Abstract

Purpose

The purpose of this study is to evaluate the presence of clinical and radiological femoroacetabular impingement (FAI) in elite ice hockey players and compare it to a control group of non-athletes.

Methods

Forty participants (20 non-athletes and 20 elite ice hockey athletes) underwent an evaluation of their hip joint, including assessment of range of motion and special provocative impingement tests. Two musculoskeletal radiologists assessed MRIs completed on each participant for radiological findings associated with FAI, including alpha angle, acetabular version angle, acetabular depth, and/or a lateral centre edge angle, and findings of labral and cartilage degeneration. A comparative analysis of the clinical and radiological findings was subsequently completed.

Results

There was a significant difference in the radiological CAM impingement measured by mean alpha angle between both groups (non-athletes: 43.2 degrees, SD 9.7; and athletes: 54.2 degrees, SD 12 (p = 0.003)). There were no statistically significant differences between the groups upon evaluating PINCER impingement. There were no statistically significant differences in clinical examination findings between both groups.

Conclusion

MRI evidence suggests that CAM impingement is more common in the elite ice hockey athlete in comparison with non-athletes. However, as this is a pilot study examining findings in asymptomatic individuals, there is a need for a longitudinal prospective cohort study. In keeping with this, sufficient, long-term follow-up is required to assess at what point, if any, these subjects with radiological findings become symptomatic.

Level of evidence

Cross-sectional cohort study, Level III.

Agricola R, Bessems JH, Ginai AZ, Heijboer MP, van der Heijden RA, Verhaar JA, Weinans H, Waarsing JH (2012) The development of cam-type deformity in adolescent and young male soccer players. Am J Sports Med 40(5):1099–1106PubMedCrossRef

Beaulé P, Hack K, Di Primio G, Rakhra K (2011) Prevalence of cam type FAI morphology in 200 asymptomatic volunteers 93-B(3 Suppl):250

Beaule PE, Zaragoza E, Motamedi K, Copelan N, Dorey FJ (2005) Three-dimensional computed tomography of the hip in the assessment of femoroacetabular impingement. J Orthop Res 23(6):1286–1292PubMedCrossRef

Beck M, Kalhor M, Leunig M, Ganz R (2005) Hip morphology influences the pattern of damage to the acetabular cartilage: femoroacetabular impingement as a cause of early osteoarthritis of the hip. J Bone Jt Surg 87(7):1012–1018CrossRef

Bedi A, Dolan M, Leunig M, Kelly BT (2011) Static and dynamic mechanical causes of hip pain. Arthroscopy 27(2):235–251PubMedCrossRef

Byrd J, Jones K (2004) Diagnostic accuracy of clinical assessment, magnetic resonance imaging, magnetic resonance arthrography, and intra-articular injection in hip arthroscopy patients. Am J Sports Med 32(7):1668–1674PubMedCrossRef

Filigenzi J, Bredella M (2008) MR imaging of femoroacetabular impingement. Appl Radiol 37(4):12–19

Ganz R, Leunig M, Leunig-Ganz K, Harris W (2008) The etiology of osteoarthritis of the hip: an integrated mechanical concept. Clin Orthop Relat Res 466:264–272PubMedCentralPubMedCrossRef

Ganz R, Parvizi J, Beck M, Leunig M, Notzli H, Siebenrock KA (2003) Femoroacetabular impingement: a cause for osteoarthritis of the hip. Clin Orthop Relat Res 417:112–120PubMed

10.

Ganz R, Gill TJ, Gautier E, Ganz K, Krugel N, Berlemann U (2001) Surgical dislocation of the adult hip a technique with full access to the femoral head and acetabulum without the risk of avascular necrosis. J Bone Jt Surg Br 83(8):1119–1124CrossRef

11.

Hack K, Di Primio G, Rakhra K, Beaule P (2010) Prevalence of cam-type femoroacetabular impingement morphology in asymptomatic volunteers. J Bone Jt Surg Am 92(14):2436–2444CrossRef

12.

Hart E, Metkar U, Rebello G, Grottkau B (2009) Femoroacetabular impingement in adolescents and young adults. Orthop Nurs 28(3):117–124PubMedCrossRef

13.

Hunt D, Clohisy J, Prather H (2007) Acetabular tears of the hip in women. Phys Med Rehabil Clin N Am 18(3):497–520PubMedCrossRef

14.

Kapron A, Anderson A, Aoki S, Phillips L, Petron D, Toth R, Peters C (2011) Radiographic prevalence of femoroacetabular impingement in collegiate football players. J Bone Jt Surg Am 93:e111(1–10)

15.

Keeney J, Peelle M, Jackson J, Rubin D, Maloney W, Clohisy J (2004) Magnetic resonance arthrography versus arthroscopy in the evaluation of articular hip pathology. Clin Orthop Relat Res 429:163–169PubMedCrossRef

16.

Klaue K, Durnin CW, Ganz R (1991) The acetabular rim syndrome. A clinical presentation of dysplasia of the hip. J Bone Jt Surg Am 73-B:423–429

17.

Klenke F, Siebenrock K (2012) Pathomorphology and treatment of femoroacetabular impingement. Instr Course Lect 61:263–272PubMed

18.

Kuhlman G, Domb B (2009) Hip impingement: identifying and treating a common cause of hip pain. Ann Fam Med 80(12):1429–1434

19.

Lequesne M, Bellaiche L (2012) Anterior femoroacetabular impingement: an update. Jt Bone Spine 79(3):249–255CrossRef

20.

Leunig M, Ganz R, Femoroacetabular impingement (2005) A common cause of hip complaints leading to arthrosis. Unfallchirurg 108(1):9–10,12–7

21.

Martin R, Sekiya J (2008) The interrater reliability of 4 clinical tests used to assess individuals with musculoskeletal hip pain. J Orthop Sports Phys Ther 38(2):71–77PubMedCrossRef

22.

McRae R (1997) Clinical orthopaedic examination, 4th edn. Longman Singapore Publishers (Pte) Ltd, Singapore, pp 155–188

23.

Notzli HP, Wyss TF, Stoecklin CH, Schmid MR, Treiber K, Hodler J (2011) The contour of the femoral head-neck junction as a predictor for the risk of anterior impingement. J Bone Jt Surg Br 84(4):556–560CrossRef

24.

Philippon M, Schenker M (2006) Arthroscopy for the treatment of femoroacetabular impingement in the athlete. Clin Sports Med 25(2):299–308PubMedCrossRef

25.

Pollard TCB, Villar RN, Williams M, Norton MR, Fern ED, Murray DW, Carr, AJ (2010) Genetic influences in the aetiology of femoroacetabular impingement: a sibling study. J Bone Jt Surg Br 92-B:209–216

26.

Reagan K, Meister K, Horodyski M, Warner D, Carruthers C, Wilk K (2002) Humeral retroversion and its relationship to glenohumeral rotation in the shoulder of college baseball players. Am J Sports Med 30(3):354–360PubMed

27.

Stull J, Philippon M, LaPrade R (2011) At-risk’ positioning and hip biomechanics of the Peewee ice hockey sprint start. Am J Sports Med 39 Suppl:29S–35S

28.

Tannast M, Siebenrock K, Anderson S (2007) Femoroacetabular impingement: radiographic diagnosis—what the radiologist should know. AJR Am J Roentgenol 188(6):1540–1552PubMedCrossRef

29.

Wheeless C (1996) CE Angle of Wilberg” wheeless’ textbook of orthopedics [Internet]. In: duke orthopaedics

Title: Femoroacetabular impingement in elite ice hockey players
Authors: Olufemi R. Ayeni
Kamal Banga
Mohit Bhandari
Zeev Maizlin
Darren de SA
Dmitry Golev
Srinivasan Harish
Forough Farrokhyar
Publication date: 01-04-2014
Publisher: Springer Berlin Heidelberg
Published in: Knee Surgery, Sports Traumatology, Arthroscopy / Issue 4/2014
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-013-2598-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Femoroacetabular impingement in elite ice hockey players

Abstract

Purpose

Methods

Results

Conclusion

Level of evidence

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Level of evidence

Please log in to get access to this content

Other articles of this Issue 4/2014

Arthroscopic treatment of recurrent acetabulum osteoid osteoma

A painful squat test provides limited diagnostic utility in CAM-type femoroacetabular impingement

Pre-operative intra-articular hip injection as a predictor of short-term outcome following arthroscopic management of femoroacetabular impingement

Complications in hip arthroscopy: necessity of supervision during the learning curve

The hip fluid seal—Part II: The effect of an acetabular labral tear, repair, resection, and reconstruction on hip stability to distraction

Can hip impingement be mistaken for tendon pain in the groin? A long-term follow-up of tenotomy for groin pain in athletes