Prevalence of hip femoroacetabular impingement deformities in high-level (La Liga) male professional football players

Abstract

Background: Femoroacetabular impingement (FAI) is considered one of the main causes of hip osteoarthritis in young adults, especially in athletes. In recent years, morphological changes in FAI in the hip have been linked to early and intense sports participation, but studying top-level athlete samples is not easy. This paper presents the prevalence of FAI radiological markers in 120 active white male professional football players in the Spanish First Division League (La Liga) and compares the morphological changes with those of a control group of healthy individuals without significant sport activity.

Methods: The precontract medical evaluation hip X-rays of 120 white male professional football players from four different First Division Spanish football teams were prospectively filed and retrospectively reviewed by a dedicated skeletal radiologist. The footballers' hip X-rays were compared with those of a control group of 80 healthy individuals (age-sex matched) without significant sport activity (obtained from routine work medical checks).

Results: The femoral head-neck deformity associated with the Cam type of femoroacetabular impingement was observed in 61.6% of professional football players and only in 11.6% of the control group (p <0.01). The presence of "herniation pit" (11.6%) and os acetabuli (13.3%) also reached statistical significance in the professional football players group. In the other analyzed parameters, no statistically significant differences between the groups were observed.

Conclusions: White professional top-level football players have an increased incidence of abnormal lateral epiphyseal extension ("pistol grip deformity"), os acetabuli and herniation pits.

Keywords: Femoroacetabular impingement; Footballer’s hip; Hip deformity; Professional football players.

Fig. 1

CAM type deformity (Blue arrow): prominence in the anterosuperior aspect of the proximal femur at the level of the head-neck junction) in the left hip of a 24 year old footballer accompanied by a pincer deformity (overcoverage) of the margin of the acetabulum (yellow arrow)

Fig. 2

CAM type deformity (Blue arrow): prominence in the anterosuperior aspect of the proximal femur at the level of the head-neck junction in the right hip of a 31 year old footballer accompanied by a small os acetabuli at the margin of the acetabulum (Yellow arrow). In this case, the CAM prominence causes a loss of sphericity of the femoral head and a ‘bumpy‘ head neck-junction