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Prevalence of cam-type deformity and hip pain in elite ice hockey players before and after the end of growth.
Am J Sports Med 2013; 41(10):2308-13AJ

Abstract

BACKGROUND

Elite-level sports activities have been associated with hip osteoarthritis and cam-type deformity.

PURPOSE

To analyze the appearance and prevalence of an abnormal cam-type deformity of the proximal femur and its potential association to hip pain in adolescent and young adult athletes.

STUDY DESIGN

Cross-sectional study; Level of evidence, 3.

METHODS

A total of 77 elite-level male ice hockey players were evaluated with a questionnaire, clinical examination, and magnetic resonance imaging. The questionnaire and clinical examination were used to determine whether the hip being evaluated was symptomatic and what the internal rotation of the hip was. Magnetic resonance imaging was used to determine physeal status (open/closed) and α angle of the cranial half of the proximal femur using a standard clockface system.

RESULTS

The mean age of the patients was 16.5 years (range, 9-36 years); 15 of 77 (19.5%) athletes had a history of hip pain and a positive impingement test finding. The α angles were higher in athletes with closed physes versus open physes (58° vs 49°, respectively; P < .001). Symptomatic athletes had higher α angles compared with asymptomatic athletes at the 12-o'clock (52° vs 46°, respectively; P = .022), 1-o'clock (62° vs 52°, respectively; P < .001), and 2-o'clock (59° vs 50°, respectively; P < .001) positions. Internal rotation was significantly decreased in symptomatic compared with asymptomatic athletes (17° vs 23°, respectively). Higher α angles in the anterosuperior quadrant were significantly associated with decreased internal rotation.

CONCLUSION

The data suggest that playing ice hockey at an elite level during childhood is associated with an increased risk for cam-type deformity and hip pain after physeal closure.

Authors+Show Affiliations

Klaus A. Siebenrock, Department of Orthopedic Surgery, University of Bern, Inselspital, CH-3010 Bern, Switzerland. klaus.siebenrock@insel.ch.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

23911701

Citation

Siebenrock, Klaus A., et al. "Prevalence of Cam-type Deformity and Hip Pain in Elite Ice Hockey Players Before and After the End of Growth." The American Journal of Sports Medicine, vol. 41, no. 10, 2013, pp. 2308-13.
Siebenrock KA, Kaschka I, Frauchiger L, et al. Prevalence of cam-type deformity and hip pain in elite ice hockey players before and after the end of growth. Am J Sports Med. 2013;41(10):2308-13.
Siebenrock, K. A., Kaschka, I., Frauchiger, L., Werlen, S., & Schwab, J. M. (2013). Prevalence of cam-type deformity and hip pain in elite ice hockey players before and after the end of growth. The American Journal of Sports Medicine, 41(10), pp. 2308-13. doi:10.1177/0363546513497564.
Siebenrock KA, et al. Prevalence of Cam-type Deformity and Hip Pain in Elite Ice Hockey Players Before and After the End of Growth. Am J Sports Med. 2013;41(10):2308-13. PubMed PMID: 23911701.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevalence of cam-type deformity and hip pain in elite ice hockey players before and after the end of growth. AU - Siebenrock,Klaus A, AU - Kaschka,Iris, AU - Frauchiger,Lars, AU - Werlen,Stefan, AU - Schwab,Joseph M, Y1 - 2013/08/02/ PY - 2013/8/6/entrez PY - 2013/8/6/pubmed PY - 2014/5/21/medline KW - cam-type deformity KW - femoroacetabular impingement KW - physeal growth SP - 2308 EP - 13 JF - The American journal of sports medicine JO - Am J Sports Med VL - 41 IS - 10 N2 - BACKGROUND: Elite-level sports activities have been associated with hip osteoarthritis and cam-type deformity. PURPOSE: To analyze the appearance and prevalence of an abnormal cam-type deformity of the proximal femur and its potential association to hip pain in adolescent and young adult athletes. STUDY DESIGN: Cross-sectional study; Level of evidence, 3. METHODS: A total of 77 elite-level male ice hockey players were evaluated with a questionnaire, clinical examination, and magnetic resonance imaging. The questionnaire and clinical examination were used to determine whether the hip being evaluated was symptomatic and what the internal rotation of the hip was. Magnetic resonance imaging was used to determine physeal status (open/closed) and α angle of the cranial half of the proximal femur using a standard clockface system. RESULTS: The mean age of the patients was 16.5 years (range, 9-36 years); 15 of 77 (19.5%) athletes had a history of hip pain and a positive impingement test finding. The α angles were higher in athletes with closed physes versus open physes (58° vs 49°, respectively; P < .001). Symptomatic athletes had higher α angles compared with asymptomatic athletes at the 12-o'clock (52° vs 46°, respectively; P = .022), 1-o'clock (62° vs 52°, respectively; P < .001), and 2-o'clock (59° vs 50°, respectively; P < .001) positions. Internal rotation was significantly decreased in symptomatic compared with asymptomatic athletes (17° vs 23°, respectively). Higher α angles in the anterosuperior quadrant were significantly associated with decreased internal rotation. CONCLUSION: The data suggest that playing ice hockey at an elite level during childhood is associated with an increased risk for cam-type deformity and hip pain after physeal closure. SN - 1552-3365 UR - https://www.unboundmedicine.com/medline/citation/23911701/Prevalence_of_cam_type_deformity_and_hip_pain_in_elite_ice_hockey_players_before_and_after_the_end_of_growth_ L2 - http://journals.sagepub.com/doi/full/10.1177/0363546513497564?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -