. 2021 Mar;29(3):323-334.

doi: 10.1016/j.joca.2020.12.013. Epub 2020 Dec 30.

Prevalence of early hip OA features on MRI in high-impact athletes. The femoroacetabular impingement and hip osteoarthritis cohort (FORCe) study

J J Heerey¹, R Srinivasan², R Agricola³, A Smith⁴, J L Kemp⁵, T Pizzari⁶, M G King⁷, P R Lawrenson⁸, M J Scholes⁹, R B Souza¹⁰, T Link¹¹, S Majumdar¹², K M Crossley¹³

Affiliations

¹ La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia. Electronic address: j.heerey@latrobe.edu.au.
² Department of Radiology and Biomedical Imaging, University of California-San Francisco, CA, USA. Electronic address: ramya.srinivasan@ucsf.edu.
³ Department of Orthopaedics, Erasmus University Medical Center, Rotterdam, The Netherlands. Electronic address: r.agricola@erasmusmc.nl.
⁴ School of Physiotherapy and Exercise Science, Curtain University, Perth, Australia. Electronic address: anne.smith@exchange.curtin.edu.au.
⁵ La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia. Electronic address: j.kemp@latrobe.edu.au.
⁶ La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia. Electronic address: t.pizzari@latrobe.edu.au.
⁷ La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia. Electronic address: m.king@latrobe.edu.au.
⁸ The University of Queensland, St Lucia, Australia. Electronic address: p.lawrenson@uq.edu.au.
⁹ La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia. Electronic address: m.scholes@latrobe.edu.au.
¹⁰ Department of Radiology and Biomedical Imaging, University of California-San Francisco, CA, USA; Department of Physical Therapy and Rehabilitation Science, University of California-San Francisco, CA, USA. Electronic address: richard.souza@ucsf.edu.
¹¹ Department of Radiology and Biomedical Imaging, University of California-San Francisco, CA, USA. Electronic address: thomas.link@ucsf.edu.
¹² Department of Radiology and Biomedical Imaging, University of California-San Francisco, CA, USA. Electronic address: sharmila.majumdar@ucsf.edu.
¹³ La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia. Electronic address: k.crossley@latrobe.edu.au.

PMID: 33387651
PMCID: PMC8900484
DOI: 10.1016/j.joca.2020.12.013

Prevalence of early hip OA features on MRI in high-impact athletes. The femoroacetabular impingement and hip osteoarthritis cohort (FORCe) study

J J Heerey et al. Osteoarthritis Cartilage. 2021 Mar.

. 2021 Mar;29(3):323-334.

doi: 10.1016/j.joca.2020.12.013. Epub 2020 Dec 30.

Authors

J J Heerey¹, R Srinivasan², R Agricola³, A Smith⁴, J L Kemp⁵, T Pizzari⁶, M G King⁷, P R Lawrenson⁸, M J Scholes⁹, R B Souza¹⁰, T Link¹¹, S Majumdar¹², K M Crossley¹³

Affiliations

¹ La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia. Electronic address: j.heerey@latrobe.edu.au.
² Department of Radiology and Biomedical Imaging, University of California-San Francisco, CA, USA. Electronic address: ramya.srinivasan@ucsf.edu.
³ Department of Orthopaedics, Erasmus University Medical Center, Rotterdam, The Netherlands. Electronic address: r.agricola@erasmusmc.nl.
⁴ School of Physiotherapy and Exercise Science, Curtain University, Perth, Australia. Electronic address: anne.smith@exchange.curtin.edu.au.
⁵ La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia. Electronic address: j.kemp@latrobe.edu.au.
⁶ La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia. Electronic address: t.pizzari@latrobe.edu.au.
⁷ La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia. Electronic address: m.king@latrobe.edu.au.
⁸ The University of Queensland, St Lucia, Australia. Electronic address: p.lawrenson@uq.edu.au.
⁹ La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia. Electronic address: m.scholes@latrobe.edu.au.
¹⁰ Department of Radiology and Biomedical Imaging, University of California-San Francisco, CA, USA; Department of Physical Therapy and Rehabilitation Science, University of California-San Francisco, CA, USA. Electronic address: richard.souza@ucsf.edu.
¹¹ Department of Radiology and Biomedical Imaging, University of California-San Francisco, CA, USA. Electronic address: thomas.link@ucsf.edu.
¹² Department of Radiology and Biomedical Imaging, University of California-San Francisco, CA, USA. Electronic address: sharmila.majumdar@ucsf.edu.
¹³ La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia. Electronic address: k.crossley@latrobe.edu.au.

PMID: 33387651
PMCID: PMC8900484
DOI: 10.1016/j.joca.2020.12.013

Abstract

Objective: To compare early hip osteoarthritis (OA) features on magnetic resonance imaging (MRI) in high-impact athletes with and without hip and/or groin pain, and to evaluate associations between early hip OA features, the International Hip Outcome Tool (iHOT33) and Copenhagen Hip and Groin Outcome Score (HAGOS).

Design: This case-control study evaluated data of the femoroacetabular impingement and hip osteoarthritis cohort (FORCe). One hundred and eighty-two symptomatic (hip and/or groin pain >6 months and positive flexion-adduction-internal-rotation (FADIR) test) and 55 pain-free high-impact athletes (soccer or Australian football (AF)) without definite radiographic hip OA underwent hip MRI. The Scoring Hip Osteoarthritis with MRI (SHOMRI) method quantified and graded the severity of OA features. Each participant completed the iHOT33 and HAGOS.

Results: Hip and/or groin pain was associated with higher total SHOMRI (0-96) (mean difference 1.4, 95% CI: 0.7-2.2), labral score (adjusted incidence rate ratio (aIRR) 1.33, 95% CI: 1.1-1.6). Differences in prevalence of cartilage defects, labral tears and paralabral cysts between symptomatic and pain-free participants were inconclusive. There was a lower prevalence of effusion-synovitis in symptomatic participants when compared to pain-free participants (adjusted odds ratio (aOR) 0.46 (95% CI: 0.3-0.8). Early hip OA features were not associated with iHOT33 or HAGOS.

Conclusions: A complex and poorly understood relationship exists between hip and/or groin pain and early hip OA features present on MRI in high-impact athletes without radiographic OA. Hip and/or groin pain was associated with higher SHOMRI and labral scores.

Keywords: Hip osteoarthritis; Hip pain; MRI; Osteoarthritis.

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Conflict of interest statement

Competing interests

The authors declare they have no competing interests.

Figures

**Fig. 1**
Flowchart of symptomatic participants.

**Fig. 2**
Flowchart of control participants.

**Fig. 3. Prevalence of individual osteoarthritis (OA) features in symptomatic, other and control hips in football players.**
Intra-articular loose bodies not included in figure due to low prevalence in symptom groups (symptomatic 1 %, other and control hips feature absent)

See this image and copyright information in PMC

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Prevalence of early hip OA features on MRI in high-impact athletes. The femoroacetabular impingement and hip osteoarthritis cohort (FORCe) study

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Prevalence of early hip OA features on MRI in high-impact athletes. The femoroacetabular impingement and hip osteoarthritis cohort (FORCe) study

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