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Prevalence of increased alpha angles as a measure of cam-type femoroacetabular impingement in youth ice hockey players.
Am J Sports Med 2013; 41(6):1357-62AJ

Abstract

BACKGROUND

It has been reported that relative to other sports participants, ice hockey players suffer from cam-type femoroacetabular impingement (FAI) in higher numbers. α angles have been reported to increase with the likelihood of symptomatic FAI. It is unclear how prevalent increased α angles, commonly associated with cam FAI, are in asymptomatic young ice hockey players.

HYPOTHESIS

There would be a higher prevalence of α angles associated with cam FAI in youth ice hockey players than in a non-hockey-playing (skier) youth control group.

STUDY DESIGN

Cohort study; Level of evidence, 3.

METHODS

A total of 61 asymptomatic youth ice hockey players (aged 10-18 years) and 27 youth skiers (controls) (aged 10-18 years) underwent a clinical hip examination consisting of the flexion/abduction/external rotation (FABER) distance test, impingement testing, and measurement of hip internal rotation. The hip α angle was measured by magnetic resonance imaging, and labral tears and articular cartilage lesions were documented. Hockey players were grouped according to their USA Hockey classification as peewees (ages 10-12 years), bantams (ages 13-15 years), and midgets (ages 16-19 years).

RESULTS

Overall, ice hockey players had significantly higher α angles than did the control group, and hockey players had a significant correlation between increased age and increased α angles, while the control group did not. In the ice hockey group, 75% had an α angle of ≥55°, while in the skier group, 42% had an α angle of ≥55° (P < .006). Hockey players were 4.5 times more likely to have an α angle commonly associated with cam impingement than skiers. Midget players had the highest risk of increased α angles.

CONCLUSION

Even at young ages, ice hockey players have a greater prevalence of α angles associated with cam FAI than do skier-matched controls. Properties inherent to ice hockey likely enhance the development of a bony overgrowth on the femoral neck, leading to cam FAI.

Authors+Show Affiliations

Steadman Philippon Research Institute, Attn: Center for Outcomes-based Orthopaedic Research, 181 West Meadow Drive, Suite 1000, Vail, CO 81657, USA. drphilippon@sprivail.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23562808

Citation

Philippon, Marc J., et al. "Prevalence of Increased Alpha Angles as a Measure of Cam-type Femoroacetabular Impingement in Youth Ice Hockey Players." The American Journal of Sports Medicine, vol. 41, no. 6, 2013, pp. 1357-62.
Philippon MJ, Ho CP, Briggs KK, et al. Prevalence of increased alpha angles as a measure of cam-type femoroacetabular impingement in youth ice hockey players. Am J Sports Med. 2013;41(6):1357-62.
Philippon, M. J., Ho, C. P., Briggs, K. K., Stull, J., & LaPrade, R. F. (2013). Prevalence of increased alpha angles as a measure of cam-type femoroacetabular impingement in youth ice hockey players. The American Journal of Sports Medicine, 41(6), pp. 1357-62. doi:10.1177/0363546513483448.
Philippon MJ, et al. Prevalence of Increased Alpha Angles as a Measure of Cam-type Femoroacetabular Impingement in Youth Ice Hockey Players. Am J Sports Med. 2013;41(6):1357-62. PubMed PMID: 23562808.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevalence of increased alpha angles as a measure of cam-type femoroacetabular impingement in youth ice hockey players. AU - Philippon,Marc J, AU - Ho,Charles P, AU - Briggs,Karen K, AU - Stull,Justin, AU - LaPrade,Robert F, Y1 - 2013/04/05/ PY - 2013/4/9/entrez PY - 2013/4/9/pubmed PY - 2013/12/16/medline KW - cam lesion KW - femoroacetabular impingement KW - ice hockey KW - magnetic resonance imaging KW - α angle SP - 1357 EP - 62 JF - The American journal of sports medicine JO - Am J Sports Med VL - 41 IS - 6 N2 - BACKGROUND: It has been reported that relative to other sports participants, ice hockey players suffer from cam-type femoroacetabular impingement (FAI) in higher numbers. α angles have been reported to increase with the likelihood of symptomatic FAI. It is unclear how prevalent increased α angles, commonly associated with cam FAI, are in asymptomatic young ice hockey players. HYPOTHESIS: There would be a higher prevalence of α angles associated with cam FAI in youth ice hockey players than in a non-hockey-playing (skier) youth control group. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: A total of 61 asymptomatic youth ice hockey players (aged 10-18 years) and 27 youth skiers (controls) (aged 10-18 years) underwent a clinical hip examination consisting of the flexion/abduction/external rotation (FABER) distance test, impingement testing, and measurement of hip internal rotation. The hip α angle was measured by magnetic resonance imaging, and labral tears and articular cartilage lesions were documented. Hockey players were grouped according to their USA Hockey classification as peewees (ages 10-12 years), bantams (ages 13-15 years), and midgets (ages 16-19 years). RESULTS: Overall, ice hockey players had significantly higher α angles than did the control group, and hockey players had a significant correlation between increased age and increased α angles, while the control group did not. In the ice hockey group, 75% had an α angle of ≥55°, while in the skier group, 42% had an α angle of ≥55° (P < .006). Hockey players were 4.5 times more likely to have an α angle commonly associated with cam impingement than skiers. Midget players had the highest risk of increased α angles. CONCLUSION: Even at young ages, ice hockey players have a greater prevalence of α angles associated with cam FAI than do skier-matched controls. Properties inherent to ice hockey likely enhance the development of a bony overgrowth on the femoral neck, leading to cam FAI. SN - 1552-3365 UR - https://www.unboundmedicine.com/medline/citation/23562808/Prevalence_of_increased_alpha_angles_as_a_measure_of_cam_type_femoroacetabular_impingement_in_youth_ice_hockey_players_ L2 - http://journals.sagepub.com/doi/full/10.1177/0363546513483448?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -