Advertisement

International Orthopaedics

, Volume 38, Issue 12, pp 2571–2576 | Cite as

Prevalence of femoro-acetabular impingement in international competitive track and field athletes

  • Matthias LahnerEmail author
  • Simone Bader
  • Philipp Alexander Walter
  • Christian Duif
  • Christoph von Schulze Pellengahr
  • Carsten Lukas
  • Andreas Ficklscherer
  • Stefan Fickert
  • Marco Hagen
Original Paper

Abstract

Purpose

The aim of our study was to analyse the prevalence of femoro-acetabular impingement (FAI) in national elite track and field athletes compared to peers using magnetic resonance imaging (MRI) and clinical examination including impingement tests.

Methods

A total of 44 participants (22 national elite track and field athletes and 22 non-athletes) underwent an MRI for radiological findings associated with FAI, including alpha angle, lateral centre edge angle (CEA), findings of labral and cartilage lesions. The study group was furthermore investigated by the hip outcome score (HOS) and a clinical hip examination including range of motion (ROM) and impingement tests.

Results

Concerning the cam impingement, there was a significant difference measured by mean alpha angle between the athlete group (52.2 ± 7.29°) and the control group (48.1 ± 5.45°, P = 0.004). Eleven athletes showed a cam impingement, while two probands of the control group had a pincer impingement and one a mixed form (P = 0.0217). There was no statistically significant difference concerning the CEA upon evaluating pincer impingement. Seven track and field athletes had a positive impingement test, whereof three had an increased alpha angle >55°. No participant of the control group showed pathological results in the impingement test (P = 0.0121).

Conclusions

MRI evidence and clinical examination suggest that cam impingement is more common in elite athletes in comparison to non-athletes. At a professional level, the intense practice of track and field athletics is susceptible for FAI.

Keywords

Femoroacetabular impingement Alpha angle Lateral centre edge angle Magnetic resonance imaging Cam Pincer Track and field athlete 

Notes

Acknowledgments

The study was supported by a donation of LOCALITE, Biomedical Visualization System, Germany. The authors acknowledge Dr. Andreas Falarzik, Coach Michael Huke and the athletes of the Olympic Training Center of Westfalia/Germany.

References

  1. 1.
    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 osteoarthritits of the hip. J Bone Joint Surg (Br) 87(7):1012–1018CrossRefGoogle Scholar
  2. 2.
    Ganz R, Leunig M, Leunig-Ganz K, Harris WH (2008) The etiology of osteoarthritis of the hip: an integrated mechanical concept. Clin Orthop Relat Res 466(2):264–272PubMedCentralPubMedCrossRefGoogle Scholar
  3. 3.
    Leunig M, Ganz R (2005) Femoroacetabular impingement. A common cause of hip complaints leading to arthrosis. Unfallchirurg 108(1):9–10, 12-17PubMedCrossRefGoogle Scholar
  4. 4.
    Iman S, Khanduja V (2011) Current concepts in the diagnosis and management of femoroacetabular impingement. Int Orthop 35(10):1427–1435CrossRefGoogle Scholar
  5. 5.
    Lesquesne M, Bellaiche L (2012) Anterior femoroacetabular impingement: an update. Joint Bone Spine 79(3):249–255CrossRefGoogle Scholar
  6. 6.
    Ganz R, Parvizi J, Beck M, Leunig M, Nötzli H, Siebenrock KA (2003) Femoroacetabular impingement: a cause for osteoarthritis of the hip. Clin Orthop Relat Res 417:112–120PubMedGoogle Scholar
  7. 7.
    Nötzli HP, Wyss TF, Stoecklin CH, Schmid MR, Treiber K, Hodler J (2002) The contour of the femoral head-neck junction as a predictor for the risk of anterior impingement. J Bone Joint Surg (Br) 84(4):556–560CrossRefGoogle Scholar
  8. 8.
    Hart E, Metkar U, Rebello G, Grottkau B (2009) Femoroacetabular impingement in adolescents and young adults. Orthop Nurs 28(3):117–124PubMedCrossRefGoogle Scholar
  9. 9.
    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):1099–1106PubMedCrossRefGoogle Scholar
  10. 10.
    Lahner M, Walter PA, von Schulze Pellengahr C, Hagen M, von Engelhardt LV, Lukas C (2014) Comparative study of femoroacetabular impingement (FAI) prevalence in male semiprofessional and amateur soccer players. Arch Orthop Trauma Surg 134(8):1135–1141Google Scholar
  11. 11.
    Kapron AL, Anderson AE, Aoki SK, Phillips LG, Petron DJ, Toth R, Peters CL (2011) Radiographic prevalence of femoroacetabular impingement in collegiate football players: AAOS Exhibit Selection. J Bone Joint Surg Am 93:e111, 1–10PubMedCrossRefGoogle Scholar
  12. 12.
    Siebenrock KA, Kaschka I, Frauchiger L, Werlen S, Schwab JM (2013) Prevalence of cam-type deformity and hip pain in elite ice hockey players before and after the end of growth. Am J Sports Med 48(1):4–10Google Scholar
  13. 13.
    Ayeni OR, Banga K, Bhandari M, Maizlin Z, de Sa D, Golev D, Harish S, Farrokhyar F (2014) Femoroacetabular impingement in elite ice hockey players. Knee Surg Sports Traumatol Arthrosc 22(4):920–925PubMedCrossRefGoogle Scholar
  14. 14.
    Hack K, Di Primio G, Rakhra K, Beaulé PE (2010) Prevalence of cam-type femoroacetabular impingement morphology in asymptomatic volunteers. J Bone Joint Surg Am 92(14):2436–2444PubMedCrossRefGoogle Scholar
  15. 15.
    Martin RL, Kelly BT, Philippon MJ (2006) Evidence of validity for the hip outcome score. Arthroscopy 22(12):1304–1311PubMedCrossRefGoogle Scholar
  16. 16.
    Martin RL, Sekiya JK (2008) The interrater reliability of 4 clinical tests used to assess individuals with musculoskeletal hip pain. J Orthop Sports Phys Ther 38(2):71–77PubMedCrossRefGoogle Scholar
  17. 17.
    Kassarjian A, Yoon LS, Belzile E, Connolly SA, Millis MB, Palmer WE (2005) Triad of MR arthrographic findings in patients with cam-type femoroacetabular impingement. Radiology 236(2):588–592PubMedCrossRefGoogle Scholar
  18. 18.
    Reichenbach S, Jüni P, Werlen S, Nüesch E, Pfirmann CW, Trelle S, Odermatt A, Hofstetter W, Ganz R, Leunig M (2010) Prevalence of cam-type deformity on hip magnetic resonance imaging in young males: a cross-selectional study. Arthritis Care Res (Hoboken) 62(9):1319–1327CrossRefGoogle Scholar
  19. 19.
    Kapron AL, Anderson AE, Aoki SK, Phillips LG, Petron DJ, Toth R, Peters CL (2011) Radiographic prevalence of femoroacetabular impingement in collegiate football players: AAOS Exhibit Selection. J Bone Joint Surg Am 93(11):e111, 1–10PubMedGoogle Scholar
  20. 20.
    Tibor LM, Leunig M (2012) The pathoanatomy and arthroscopic management of femoroacetabular impingement. Bone Joint Res 1(10):245–257PubMedCentralPubMedCrossRefGoogle Scholar
  21. 21.
    Siebenrock KA, Behning A, Mamisch TC, Schwab JM (2013) Growth plate alteration precedes cam-type deformity in elite basketball players. Clin Orthop Relat Res 471(4):1084–1091PubMedCentralPubMedCrossRefGoogle Scholar
  22. 22.
    Lahner M, von Schulze Pellengahr C, Walter PA, Lukas C, Falarzik A, Daniilidis K, von Engelhardt LV, Abrahm C, Hennig EM, Hagen M (2014) Biomechanical and functional indicators in male semiprofessional soccer players with increased hip alpha angles vs. amateur soccer players. BMC Musculoskeletal Disord 15:88CrossRefGoogle Scholar
  23. 23.
    Czemy C, Oschatz E, Neuhold A, Tschauner C, Hofmann S, Kramer J (2002) MR arthrography of the hip joint. Radiologe 42(6):451–456CrossRefGoogle Scholar
  24. 24.
    Lahner M, Jahnke NL, Zirke S, Teske W, Vetter G, von Schulze PC, Daniilidis K, Hagen M, von Engelhardt LV (2014) The deviation of the mechanical leg axis correleates with an increased hip alpha angle and could be a predictor of femoroacetabular impingement. Int Orthop 38(1):19–25PubMedCrossRefGoogle Scholar
  25. 25.
    Papalia R, Del Buono A, Franceschi F, Marinozzi A, Maffulli N, Denaro V (2012) Femoroacetabular impingement syndrome management: arthroscopy or open surgery? Int Orthop 36(5):903–914PubMedCentralPubMedCrossRefGoogle Scholar
  26. 26.
    Mancini D, Fontana A (2014) Five-year results of arthroscopic techniques for the treatment of acetabular chondral lesions in femoroacetabular impingement. Int Orthop. Jun 21. [Epub ahead of print]Google Scholar

Copyright information

© SICOT aisbl 2014

Authors and Affiliations

  • Matthias Lahner
    • 1
    • 7
    Email author
  • Simone Bader
    • 1
  • Philipp Alexander Walter
    • 1
  • Christian Duif
    • 1
  • Christoph von Schulze Pellengahr
    • 2
  • Carsten Lukas
    • 3
  • Andreas Ficklscherer
    • 4
  • Stefan Fickert
    • 5
  • Marco Hagen
    • 6
  1. 1.Department of Orthopaedic Sports Surgery, St. Josef-HospitalRuhr-University BochumBochumGermany
  2. 2.Department of Orthopaedic Surgery, St. Josef-HospitalRuhr-University BochumBochumGermany
  3. 3.Department of Diagnostic and Interventional Radiology and Nuclear Medicine, St. Josef-HospitalRuhr-University BochumBochumGermany
  4. 4.Department of Orthopaedic Surgery, Physical Medicine and RehabilitationUniversity Hospital of Munich (LMU)MunichGermany
  5. 5.Sporthopaedicum StraubingStraubingGermany
  6. 6.Biomechanics Laboratory, Department of Sport and Movement SciencesUniversity of Duisburg-EssenEssenGermany
  7. 7.Department of Orthopaedic Sports SurgerySt. Josef-HospitalBochumGermany

Personalised recommendations