Skip to main content
Erschienen in: Archives of Orthopaedic and Trauma Surgery 8/2014

01.08.2014 | Arthroscopy and Sports Medicine

Comparative study of the femoroacetabular impingement (FAI) prevalence in male semiprofessional and amateur soccer players

verfasst von: Matthias Lahner, Philipp Alexander Walter, Christoph von Schulze Pellengahr, Marco Hagen, Lars Victor von Engelhardt, Carsten Lukas

Erschienen in: Archives of Orthopaedic and Trauma Surgery | Ausgabe 8/2014

Einloggen, um Zugang zu erhalten

Abstract

Introduction

Femoroacetabular impingement (FAI) represents a novel approach to the mechanical etiology of hip osteoarthritis. The cam-type femoroacetabular impingement deformity occurs frequently in young male athletes. The aim of our study was to evaluate the prevalence of FAI in male semiprofessional soccer players using clinical examination and magnetic resonance imaging (MRI), compared to amateur soccer players. In MRI, the α angle of Nötzli is determined for quantifying FAI.

Materials and methods

According to power analysis, a total of 22 asymptomatic semiprofessional soccer players with a median of 23.3 years of age (range 18–30 years) and 22 male amateur soccer players with a median of 22.5 years of age (control group, range 18–29 years) underwent an MRI to measure the hip α angle of Nötzli. The α angle of the kicking legs of the semiprofessional group and the amateur group were analyzed. The study group was moreover evaluated by the Hip Outcome Score (HOS) and a clinical hip examination including range of motion (ROM) and impingement tests.

Results

In the semiprofessional group, 19 soccer players had a right kicking leg and 1 soccer player had a left kicking leg. 2 soccer players kicked with two feet. In the semi-professional group, the mean value of the α angle of the kicking leg (57.3 ± 8.2°) was significantly higher than in the amateur group (51.7 ± 4.8°, P = 0.008). In the semi-professional group, 15 (62.5 %) of 24 kicking legs had an increased α angle >55°, while 5 (27.3 %) kicking legs of the amateur group had an α angle >55°. Five semi professional soccer players had findings in clinical examination, whereof 4 had an increased α angle >55°. No participant of the amateur group showed pathological results in the clinical examination (P = 0.0484). Overall, semiprofessional soccer players had a higher proportion of an increased α angle than the amateur group.

Conclusions

Semiprofessional players have a higher prevalence of an increased α angle in the kicking leg than the amateur group at the same age. The kicking leg is predisposed for FAI.
Literatur
1.
Zurück zum Zitat 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):920–925CrossRefPubMed 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):920–925CrossRefPubMed
2.
Zurück zum Zitat Barton C, Salineros MJ, Rakhra KS, Baulé PE (2011) Validity of the alpha angle measurement on plain radiographs in the evaluation of cam-type femoroacetabular impingement. Clin Orthop Relat Res 469(2):464–469CrossRefPubMedCentralPubMed Barton C, Salineros MJ, Rakhra KS, Baulé PE (2011) Validity of the alpha angle measurement on plain radiographs in the evaluation of cam-type femoroacetabular impingement. Clin Orthop Relat Res 469(2):464–469CrossRefPubMedCentralPubMed
3.
Zurück zum Zitat Beaulé 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):1286–1292CrossRefPubMed Beaulé 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):1286–1292CrossRefPubMed
4.
Zurück zum Zitat Beck M, Leunig M, Parvizi J, Boutier V, Wyss D, Ganz R (2004) Anterior femoroacetabular impingement: part II: midterm results of surgical treatment. Clin Orthop Relat Res 418:67–73CrossRefPubMed Beck M, Leunig M, Parvizi J, Boutier V, Wyss D, Ganz R (2004) Anterior femoroacetabular impingement: part II: midterm results of surgical treatment. Clin Orthop Relat Res 418:67–73CrossRefPubMed
5.
Zurück zum Zitat 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):1012–1018CrossRefPubMed 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):1012–1018CrossRefPubMed
6.
Zurück zum Zitat Brunner A, Hamers AT, Fitze M, Herzog RF (2010) The plain beta-angle measured on radiographs in the assessment of femoroacetabular impingement. J Bone Joint Surg Br 92(9):1203–1208CrossRefPubMed Brunner A, Hamers AT, Fitze M, Herzog RF (2010) The plain beta-angle measured on radiographs in the assessment of femoroacetabular impingement. J Bone Joint Surg Br 92(9):1203–1208CrossRefPubMed
7.
Zurück zum Zitat Clohisy JC, Nunley RM, Otto RJ, Schoenecker PL (2007) The frog-leg lateral radiographic accurately visualized hip cam impingement abnormalities. Clin Orthop Relat Res 462:115–121CrossRefPubMed Clohisy JC, Nunley RM, Otto RJ, Schoenecker PL (2007) The frog-leg lateral radiographic accurately visualized hip cam impingement abnormalities. Clin Orthop Relat Res 462:115–121CrossRefPubMed
8.
Zurück zum Zitat Czemy C, Oschatz E, Neuhold A, Tschauner C, Hofmann S, Kramer J (2002) MR arthrography of the hip joint. Radiologe 42(6):451–456 ReviewCrossRef Czemy C, Oschatz E, Neuhold A, Tschauner C, Hofmann S, Kramer J (2002) MR arthrography of the hip joint. Radiologe 42(6):451–456 ReviewCrossRef
9.
Zurück zum Zitat Dudda M, Albers C, Mamisch TC, Werlen S, Beck M (2009) Do normal radiograph exclude asphericity of the femoral head–neck junction? Clin Orthop Relat Res 476(3):651–659CrossRef Dudda M, Albers C, Mamisch TC, Werlen S, Beck M (2009) Do normal radiograph exclude asphericity of the femoral head–neck junction? Clin Orthop Relat Res 476(3):651–659CrossRef
10.
Zurück zum Zitat Eijer H, Myers SR, Ganz R (2001) Anterior femoroacetabular impingement after femoral neck fractures. J Orthop Trauma 15(7):475–481CrossRefPubMed Eijer H, Myers SR, Ganz R (2001) Anterior femoroacetabular impingement after femoral neck fractures. J Orthop Trauma 15(7):475–481CrossRefPubMed
11.
Zurück zum Zitat Epstein DM, Mc Hugh M, Yorio M, Neri B (2013) Intra-articular hip injuries in national hockey league players: a descriptive epidemiological study. Am J Sports Med 41(2):343–348CrossRefPubMed Epstein DM, Mc Hugh M, Yorio M, Neri B (2013) Intra-articular hip injuries in national hockey league players: a descriptive epidemiological study. Am J Sports Med 41(2):343–348CrossRefPubMed
12.
Zurück zum Zitat 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 417:112–120PubMed 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 417:112–120PubMed
13.
Zurück zum Zitat 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):264–272CrossRefPubMedCentralPubMed 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):264–272CrossRefPubMedCentralPubMed
14.
Zurück zum Zitat Jenkins PJ, Clement ND, Hamilton DF, Gaston P, Patton JT, Howie CR (2013) Predicting the cost-effectiveness of total hip and knee replacements: a health economic analysis. Bone Joint J 95-B(1):115–121CrossRefPubMed Jenkins PJ, Clement ND, Hamilton DF, Gaston P, Patton JT, Howie CR (2013) Predicting the cost-effectiveness of total hip and knee replacements: a health economic analysis. Bone Joint J 95-B(1):115–121CrossRefPubMed
15.
Zurück zum Zitat Johnson AC, Shaman MA, Ryan TG (2012) Femoroacetabular impingement in former high-level youth soccer players. Am J Sports Med 40(6):1342–1346CrossRefPubMed Johnson AC, Shaman MA, Ryan TG (2012) Femoroacetabular impingement in former high-level youth soccer players. Am J Sports Med 40(6):1342–1346CrossRefPubMed
16.
Zurück zum Zitat 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):e111-10 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):e111-10
17.
Zurück zum Zitat 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):588–592CrossRefPubMed 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):588–592CrossRefPubMed
18.
Zurück zum Zitat Kim WY, Hutchinson CE, Andrew JG, Allen PD (2006) The relationship between acetabular retroversion and osteoarthritis of the hip. J Bone Joint Surg Br 88(6):727–729CrossRefPubMed Kim WY, Hutchinson CE, Andrew JG, Allen PD (2006) The relationship between acetabular retroversion and osteoarthritis of the hip. J Bone Joint Surg Br 88(6):727–729CrossRefPubMed
19.
Zurück zum Zitat Lahner M, Jahnke NL, Zirke S, Teske W, Vetter G, von Schulze Pellengahr C, Daniilidis K, Hagen M, von Engelhard LV (2013) The deviation of the mechanical leg axis correlates with an increased hip alpha angle and could be a predictor for femoroacetabular impingement. Inter Orthop 38(1):19–25CrossRef Lahner M, Jahnke NL, Zirke S, Teske W, Vetter G, von Schulze Pellengahr C, Daniilidis K, Hagen M, von Engelhard LV (2013) The deviation of the mechanical leg axis correlates with an increased hip alpha angle and could be a predictor for femoroacetabular impingement. Inter Orthop 38(1):19–25CrossRef
20.
Zurück zum Zitat Leunig M, Casillas MM, Hamlet M, Hersche O, Notzli H, Slongo T, Ganz R (2000) Slipped capital femoral epiphysis: early mechanical damage to the acetabular cartilage by a prominent femoral metaphysic. Acta Orthop Scand 71(4):370–375CrossRefPubMed Leunig M, Casillas MM, Hamlet M, Hersche O, Notzli H, Slongo T, Ganz R (2000) Slipped capital femoral epiphysis: early mechanical damage to the acetabular cartilage by a prominent femoral metaphysic. Acta Orthop Scand 71(4):370–375CrossRefPubMed
21.
Zurück zum Zitat Leunig M, Ganz R (2005) Femoroacetabular impingement. A common cause of hip complaints leading to arthrosis. Unfallchirurg 108(1):9–10CrossRefPubMed Leunig M, Ganz R (2005) Femoroacetabular impingement. A common cause of hip complaints leading to arthrosis. Unfallchirurg 108(1):9–10CrossRefPubMed
22.
Zurück zum Zitat Martin RL, Kelly BT, Philippon MJ (2006) Evidence of validity for the hip outcome score. Arthroscopy 22(12):1304–1311CrossRefPubMed Martin RL, Kelly BT, Philippon MJ (2006) Evidence of validity for the hip outcome score. Arthroscopy 22(12):1304–1311CrossRefPubMed
23.
Zurück zum Zitat 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):71–77CrossRefPubMed 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):71–77CrossRefPubMed
24.
Zurück zum Zitat Myers SR, Eijer H, Ganz R (1999) Anterior femoroacetabular impingement after periacetabular osteotomy. Clin Orthop Relat Res 363:93–99CrossRefPubMed Myers SR, Eijer H, Ganz R (1999) Anterior femoroacetabular impingement after periacetabular osteotomy. Clin Orthop Relat Res 363:93–99CrossRefPubMed
25.
Zurück zum Zitat Nepple JJ, Brophy RH, Matava MJ, Wright RW, Clohisy JC (2012) Radiographic findings of femoroacetabular impingement in National Football League Combine athletes undergoing radiographs for previous hip or groin pain. Arthroscopy 28(10):1396–1403CrossRefPubMed Nepple JJ, Brophy RH, Matava MJ, Wright RW, Clohisy JC (2012) Radiographic findings of femoroacetabular impingement in National Football League Combine athletes undergoing radiographs for previous hip or groin pain. Arthroscopy 28(10):1396–1403CrossRefPubMed
26.
Zurück zum Zitat 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):556–560CrossRefPubMed 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):556–560CrossRefPubMed
27.
28.
Zurück zum Zitat Philippon MJ, Ho CP, Briggs KK, Stull J, LaPrade RF (2013) Prevalence of increased alpha angles as a measure of cam-type femoroacetabular impingement in youth ice hockey players. Am J Sports Med 41(6):1357–1362CrossRefPubMed Philippon MJ, Ho CP, Briggs KK, Stull J, LaPrade RF (2013) Prevalence of increased alpha angles as a measure of cam-type femoroacetabular impingement in youth ice hockey players. Am J Sports Med 41(6):1357–1362CrossRefPubMed
29.
Zurück zum Zitat Rakhra KS, Seikh AM, Allen D, Beaulé PE (2009) Comparison of MRI alpha angle measurement planes in femoroacetabular impingement. Clin Orthop Relat Res 467(3):660–665CrossRefPubMedCentralPubMed Rakhra KS, Seikh AM, Allen D, Beaulé PE (2009) Comparison of MRI alpha angle measurement planes in femoroacetabular impingement. Clin Orthop Relat Res 467(3):660–665CrossRefPubMedCentralPubMed
30.
Zurück zum Zitat 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):1319–1327CrossRefPubMed 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):1319–1327CrossRefPubMed
31.
Zurück zum Zitat Rolfson O, Ström O, Kärrholm J, Malchau H, Garellick G (2012) Costs related to hip disease in patients eligible for total hip arthroplasty. J Arthroplasty 27(7):1261–1266CrossRefPubMed Rolfson O, Ström O, Kärrholm J, Malchau H, Garellick G (2012) Costs related to hip disease in patients eligible for total hip arthroplasty. J Arthroplasty 27(7):1261–1266CrossRefPubMed
32.
Zurück zum Zitat Siebenrock KA, Wahab KH, Werlen S, Kalhor M, Leunig M, Ganz R (2004) Abnormal extension of the femoral head epiphysis as a cause of cam impingement. Clin Orthop Relat Res 418:54–60CrossRefPubMed Siebenrock KA, Wahab KH, Werlen S, Kalhor M, Leunig M, Ganz R (2004) Abnormal extension of the femoral head epiphysis as a cause of cam impingement. Clin Orthop Relat Res 418:54–60CrossRefPubMed
33.
Zurück zum Zitat Silvis ML, Mosher TJ, Smetana BS, Chinchilli VM, Flemming DJ, Walker EA, Black KP (2011) High prevalence of pelvic and hip magnetic resonance imaging findings in asymptomatic collegiate and professional hockey players. Am J Sports Med 39(4):715–721CrossRefPubMed Silvis ML, Mosher TJ, Smetana BS, Chinchilli VM, Flemming DJ, Walker EA, Black KP (2011) High prevalence of pelvic and hip magnetic resonance imaging findings in asymptomatic collegiate and professional hockey players. Am J Sports Med 39(4):715–721CrossRefPubMed
34.
Zurück zum Zitat Snow SW, Keret D, Scarangella S, Bowen JR (1993) Anterior impingement of the femoral head: a late phenomenon of Legg-Calvé-Perthes’ disease. J Pediatr Orthop 13(3):286–289CrossRefPubMed Snow SW, Keret D, Scarangella S, Bowen JR (1993) Anterior impingement of the femoral head: a late phenomenon of Legg-Calvé-Perthes’ disease. J Pediatr Orthop 13(3):286–289CrossRefPubMed
35.
Zurück zum Zitat Strehl A, Ganz R (2005) Anterior femoroacetabular impingement after healed femoral neck fractures. Unfallchirurg 108(4):263–273CrossRefPubMed Strehl A, Ganz R (2005) Anterior femoroacetabular impingement after healed femoral neck fractures. Unfallchirurg 108(4):263–273CrossRefPubMed
36.
Zurück zum Zitat Wyss TF, Clark JM, Weishaupt D, Nötzli HP (2007) Correlation between internal rotation and bony anatomy in the hip. Clin Orthop Relat Res 460:152–158PubMed Wyss TF, Clark JM, Weishaupt D, Nötzli HP (2007) Correlation between internal rotation and bony anatomy in the hip. Clin Orthop Relat Res 460:152–158PubMed
Metadaten
Titel
Comparative study of the femoroacetabular impingement (FAI) prevalence in male semiprofessional and amateur soccer players
verfasst von
Matthias Lahner
Philipp Alexander Walter
Christoph von Schulze Pellengahr
Marco Hagen
Lars Victor von Engelhardt
Carsten Lukas
Publikationsdatum
01.08.2014
Verlag
Springer Berlin Heidelberg
Erschienen in
Archives of Orthopaedic and Trauma Surgery / Ausgabe 8/2014
Print ISSN: 0936-8051
Elektronische ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-014-2008-6

Weitere Artikel der Ausgabe 8/2014

Archives of Orthopaedic and Trauma Surgery 8/2014 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.