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Bedeutung des femoroazetabulären Impingements im Sport

Relevance of femoroacetabular impingement in sport

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Arthroskopie Aims and scope

Zusammenfassung

Das femoroazetabuläre Impingement (FAI) ist eine häufige Erkrankung des jungen aktiven Patienten und beschreibt die Kombination aus typischen radiologischen Zeichen eines Hüft-Impingements und entsprechenden bewegungsabhängigen Beschwerden. Radiologische Impingement-Zeichen haben eine hohe Prävalenz in der Bevölkerung, sind jedoch bei Weitem nicht immer klinisch relevant. Die Prävalenz des FAI ist bei professionellen Sportlern deutlich erhöht, wobei bestimmte Sportarten besonders betroffen sind. Aufgrund der hohen Diskrepanz zwischen Bildgebung und Klinik ist die dezidierte Diagnostik mittels spezieller Impingement-Tests sowie der Ausschluss von Differenzialdiagnosen von besonderer Bedeutung. Bei der Pathogenese scheinen ethnische sowie geschlechterspezifische Faktoren eine Rolle zu spielen, insbesondere aber außerordentliche körperliche (sportliche) Belastung in einer vulnerablen Phase der Skeletogenese während der Adoleszenz ist ein Risikofaktor für die Entwicklung eines FAI. Therapie der Wahl nach Ausschöpfen der konservativen Möglichkeiten ist die arthroskopische Impingement-Resektion. Die klinischen Ergebnisse sind auch über lange Nachverfolgungszeiträume positiv und die Return-to-sport-Rate ist über verschiedene Sportarten hinweg hoch. Entscheidend hierfür ist das richtige Rehabilitationsprogramm, welches individuell auf die Anforderungen des einzelnen Sportlers zugeschnitten wird. Screening-Programme für junge Leistungssportler könnten die frühzeitige Erkennung sportspezifischer Hüftpathologien erleichtern und die Ergebnisse der Behandlung weiter verbessern.

Abstract

Femoroacetabular impingement syndrome (FAI) is a frequent pathology of young, active patients and describes the combination of typical radiological signs of hip impingement and corresponding motion-related complaints. Radiographic impingement signs have a high prevalence in the general population but are not always clinically relevant. The prevalence of FAI is significantly increased in professional athletes, with certain sports being particularly affected. Due to a high discrepancy between imaging results and clinical findings, dedicated diagnostic testing using specific impingement tests and the exclusion of differential diagnoses is of particular importance. Ethnic as well as gender-specific factors seem to play a role in the pathogenesis but especially extraordinary (athletic) physical stress in a vulnerable phase of skeletogenesis during adolescence is a risk factor for the development of FAI. The treatment of choice after conservative options have been exhausted is arthroscopic impingement resection. The clinical outcomes are positive even over long follow-up periods and the return to sport (RTS) rates are high across various types of sport. Decisive is the right rehabilitation program tailored to the individual athlete’s needs. Screening programs for young competitive athletes could facilitate the early detection of sport-specific hip pathologies and further improve treatment outcomes.

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Authors and Affiliations

  1. Klinik und Poliklinik für Unfallchirurgie, Universitätsklinik Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Deutschland

    Moritz Riedl

  2. Sporthopaedicum Straubing – Berlin – Regensburg – München, Straubing, Deutschland

    Moritz Riedl & Stefan Fickert

  3. Universitätsmedizin Mannheim, Medizinische Fakultät Mannheim, Universität Heidelberg, Heidelberg, Deutschland

    Stefan Fickert

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  1. Moritz Riedl
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Correspondence to Moritz Riedl.

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M. Riedl und S. Fickert 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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J. Paul, Basel

T. Tischer, Rostock

R. Seil, Luxemburg

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Riedl, M., Fickert, S. Bedeutung des femoroazetabulären Impingements im Sport. Arthroskopie 35, 93–99 (2022). https://doi.org/10.1007/s00142-022-00522-w

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