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Management der FAIS-Sportlerhüfte im Profifußball und „return to sports“

Management of FAIS in professional soccer athletes and return to sports

Zusammenfassung

Die Prävalenz des femoroazetabulären Impingement-Syndroms unter professionellen Fußballspielern ist hoch. Die professionellen Trainings- und Behandlungsbedingungen stellen eine effektive konservative Therapie sicher, bei der es vor allem auf dynamische Stabilität, Bewegungskontrolle, Muskelbalance und Rumpfstabilisierung ankommt. Bei dennoch bestehenden Einschränkungen muss eine Operationsindikation sorgfältig geprüft werden. Nach einer Operation ist die Wahrscheinlichkeit hoch, dass Sport auf professionellem Niveau fortgeführt werden kann, jedoch ist die notwendige Rehabilitationsphase lang. Daraus resultiert ein Spannungsfeld zwischen wirtschaftlichen und medizinischen Interessen, in dem einer guten Kommunikation und intensiven Patientenaufklärung eine große Bedeutung zukommt.

Abstract

The prevalence of femoroacetabular impingement syndrome in professional soccer athletes is high. Professional training and treatment conditions ensure an effective conservative therapy focusing on dynamic stability, motion control, muscle balance and core stability. In the case of persistent limitations, indication for surgery has to be considered carefully. The probability is high that return to a professional level of soccer is feasible. However, the period of rehabilitation is long, leading to a potential conflict area between economic and medical interests. Good communication and intensive patient education are essential.

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Abbreviations

FAIS:

Femoroazetabuläres Impingement-Syndrom

NSAR:

Nichtsteroidale Antirheumatika

Literatur

  1. Agricola R, Heijboer MP, Ginai AZ et al (2014) A cam deformity is gradually acquired during skeletal maturation in adolescent and young male soccer players: a prospective study with minimum 2‑year follow-up. Am J Sports Med 42:798–806

    Article  Google Scholar 

  2. Aoyama M, Ohnishi Y, Utsunomiya H et al (2019) A prospective, randomized, controlled trial comparing conservative treatment with trunk stabilization exercise to standard hip muscle exercise for treating Femoroacetabular impingement: a pilot study. Clin J Sport Med 29:267–275

    PubMed  PubMed Central  Google Scholar 

  3. Bastos RM, De Carvalho JJG, Da Silva SM et al (2021) Surgery is no more effective than conservative treatment for Femoroacetabular impingement syndrome: Systematic review and meta-analysis of randomized controlled trials. Clin Rehabil 35:332–341

    Article  Google Scholar 

  4. Bento AO, Falotico G, Enseki K et al (2021) Morphological changes of the hip commonly associated with femoroacetabular impingement are not correlated with rotational range of hip motion in elite soccer athletes. Sports Health 13:341–346

    Article  Google Scholar 

  5. Collins JA, Ward JP, Youm T (2014) Is prophylactic surgery for femoroacetabular impingement indicated? A systematic review. Am J Sports Med 42:3009–3015

    Article  Google Scholar 

  6. Di Pietto F, Chianca V, Zappia M et al (2018) Articular and peri-articular hip lesions in soccer players. The importance of imaging in deciding which lesions will need surgery and which can be treated conservatively? Eur J Radiol 105:227–238

    Article  Google Scholar 

  7. Dwyer T, Whelan D, Shah PS et al (2020) Operative versus nonoperative treatment of femoroacetabular impingement syndrome: a meta-analysis of short-term outcomes. Arthroscopy 36:263–273

    Article  Google Scholar 

  8. Ezechieli M, Windhagen H, Floerkemeier T et al (2019) Arthroscopic-assisted mini-open technique for the treatment of femoroacetabular impingement : video article. Orthopade 48:195–201

    CAS  Article  Google Scholar 

  9. Falotico GG, Arliani GG, Yamada AF et al (2019) Professional soccer is associated with radiographic cam and pincer hip morphology. Knee Surg Sports Traumatol Arthrosc 27:3142–3148

    Article  Google Scholar 

  10. Ganz R, Parvizi J, Beck M et al (2003) Femoroacetabular impingement: a cause for osteoarthritis of the hip. Clin Orthop Relat Res. https://doi.org/10.1097/01.blo.0000096804.78689.c2

    Article  PubMed  Google Scholar 

  11. Gao I, Safran MR (2021) Nonsurgical versus surgical management of femoroacetabular impingement: what does the current best evidence tell us. J Am Acad Orthop Surg 29:e471–e478

    Article  Google Scholar 

  12. Gard S, Christofilopoulos P, Menetrey J (2015) Femoroacetabular impingement: rehabilitation and return to sport. Rev Med Suisse 11:1450–1455

    CAS  PubMed  Google Scholar 

  13. Gatz M, Driessen A, Eschweiler J et al (2020) Arthroscopic surgery versus physiotherapy for femoroacetabular impingement: a meta-analysis study. Eur J Orthop Surg Traumatol 30:1151–1162

    Article  Google Scholar 

  14. Hipfl C, Titz M, Chiari C et al (2017) Detecting cam-type deformities on plain radiographs: what is the optimal lateral view? Arch Orthop Trauma Surg 137:1699–1705

    Article  Google Scholar 

  15. Kekatpure AL, Ahn T, Kim CH et al (2017) Clinical outcomes of an initial 3‑month trial of conservative treatment for femoroacetabular impingement. Ind J Orthop 51:681–686

    Article  Google Scholar 

  16. Locks R, Utsunomiya H, Briggs KK et al (2018) Return to play after hip arthroscopic surgery for femoroacetabular impingement in professional soccer players. Am J Sports Med 46:273–279

    Article  Google Scholar 

  17. Marquez WH, Gomez-Hoyos J, Gallo JA et al (2019) Prevalence of labrum and articular cartilage injuries of the hip on 3T magnetic resonance imaging of asymptomatic elite soccer players. Rev Esp Cir Ortop Traumatol 63:77–85

    CAS  Google Scholar 

  18. Pennock AT, Bomar JD, Johnson KP et al (2018) Nonoperative management of femoroacetabular impingement: a prospective study. Am J Sports Med 46:3415–3422

    Article  Google Scholar 

  19. Saito M, Utsunomiya H, Hatakeyama A et al (2019) Hip arthroscopic management can improve osteitis pubis and bone marrow edema in competitive soccer players with femoroacetabular impingement. Am J Sports Med 47:408–419

    Article  Google Scholar 

  20. Wall PD, Dickenson EJ, Robinson D et al (2016) Personalised hip therapy: development of a non-operative protocol to treat femoroacetabular impingement syndrome in the FASHIoN randomised controlled trial. Br J Sports Med 50:1217–1223

    Article  Google Scholar 

  21. Westermann RW, Schaver A (2021) Editorial commentary: with properly indicated and performed surgery, we can (hopefully) prevent osteoarthritis in patients with hip femoroacetabular impingement. Arthroscopy 37:1026–1027

    Article  Google Scholar 

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Correspondence to Stefan Budde.

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Interessenkonflikt

S. Budde und M. Ezechieli geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Budde, S., Ezechieli, M. Management der FAIS-Sportlerhüfte im Profifußball und „return to sports“. Orthopädie 51, 466–471 (2022). https://doi.org/10.1007/s00132-022-04257-2

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  • DOI: https://doi.org/10.1007/s00132-022-04257-2

Schlüsselwörter

  • Konservative Therapie
  • Femoroazetabuläres Impingement-Syndrom
  • Wiederaufnahme von Sportaktivitäten
  • Sportmedizin
  • Operative Behandlung

Keywords

  • Conservative treatment
  • Femoroacetabular impingement syndrome
  • Resumption of sporting activity
  • Sports medicine
  • Surgical procedure