Changes in femoral bony morphology seen on MRI over three years in youth asymptomatic hockey players
ESSKA Academy. Briggs K. 11/08/19; 284445; epESMA-39 Topic: Sports Related Injuries
Karen Briggs
Karen Briggs
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Changes in femoral bony morphology seen on MRI over three years in youth asymptomatic hockey players

ePoster - epESMA-39

Topic: Prevention in Sports

Briggs K.1, Higgins B.2, Philippon M.1
1Steadman Philippon Research Institute, Vail, United States, 2Concord Orthopaedics, Lebanon, United States

Background: Youth athletics are popular around the world. However, increasing injuries in some sports have resulted in decreasing participation. One common injury diagnosed in young athletes is femoroacetabular impingement (FAI) in the hip, which has been reported in hockey players. The purpose of this study was to determine if the prevalence of factors associated with CAM impingement, in asymptomatic young male hockey players, are associated with increased age and duration of youth hockey play.
Methods: 16 asymptomatic youth ice hockey players (ages 10 to 14 at the initial season) participated in a screening program over 3 consecutive seasons. All athletes underwent a clinical exam and limited sequence screening MRI for measurement of alpha angles and evaluation of the anterosuperior acetabular labrum. The exclusion criterion was a previous history of hip pain or hip surgery.
Results: Sixteen male youth ice hockey players were screened with an average age of 12.3 years (range 10 to 14 years) at their first screening. Nine athletes had a labral tear by MRI screening at year one, fourteen at year two and fifteen at year three. The average alpha angle was 59° (SD 8°) at year one, 70° (SD 7°) at year two and 78° (SD 10°) at year three. There was no statistically significant correlation between increasing alpha angle and change of height in the athletes. (R = 0.05). There was a statistically significant (p = 0.02) change over the three years in FABER distance, 16 cm (SD 4 cm) at year one, 18 cm (SD 6 cm) at year two, and 20 cm (SD 5 cm) and decrease in hip internal rotation, 48° (SD 11°) at year one, 36° (SD 15°) at year two, and 29° (SD 15°) at year three (p < 0.001). Femoral version, hip flexion, extension, abduction, adduction and external rotation showed no significant change.
Conclusions: Among asymptomatic, competitive, male, youth hockey players there is a high prevalence of alpha angles that are associated with CAM-type femoroacetabular impingement. Additionally, as these athletes mature through adolescence, and with increased duration of play, they lose hip internal rotation and their FABER distance test increases - both of which are also associated with CAM-type FAI. These findings place their hip “at risk” for further labral injury, articular cartilage injury and potential early onset hip arthritis.
Changes in femoral bony morphology seen on MRI over three years in youth asymptomatic hockey players

ePoster - epESMA-39

Topic: Prevention in Sports

Briggs K.1, Higgins B.2, Philippon M.1
1Steadman Philippon Research Institute, Vail, United States, 2Concord Orthopaedics, Lebanon, United States

Background: Youth athletics are popular around the world. However, increasing injuries in some sports have resulted in decreasing participation. One common injury diagnosed in young athletes is femoroacetabular impingement (FAI) in the hip, which has been reported in hockey players. The purpose of this study was to determine if the prevalence of factors associated with CAM impingement, in asymptomatic young male hockey players, are associated with increased age and duration of youth hockey play.
Methods: 16 asymptomatic youth ice hockey players (ages 10 to 14 at the initial season) participated in a screening program over 3 consecutive seasons. All athletes underwent a clinical exam and limited sequence screening MRI for measurement of alpha angles and evaluation of the anterosuperior acetabular labrum. The exclusion criterion was a previous history of hip pain or hip surgery.
Results: Sixteen male youth ice hockey players were screened with an average age of 12.3 years (range 10 to 14 years) at their first screening. Nine athletes had a labral tear by MRI screening at year one, fourteen at year two and fifteen at year three. The average alpha angle was 59° (SD 8°) at year one, 70° (SD 7°) at year two and 78° (SD 10°) at year three. There was no statistically significant correlation between increasing alpha angle and change of height in the athletes. (R = 0.05). There was a statistically significant (p = 0.02) change over the three years in FABER distance, 16 cm (SD 4 cm) at year one, 18 cm (SD 6 cm) at year two, and 20 cm (SD 5 cm) and decrease in hip internal rotation, 48° (SD 11°) at year one, 36° (SD 15°) at year two, and 29° (SD 15°) at year three (p < 0.001). Femoral version, hip flexion, extension, abduction, adduction and external rotation showed no significant change.
Conclusions: Among asymptomatic, competitive, male, youth hockey players there is a high prevalence of alpha angles that are associated with CAM-type femoroacetabular impingement. Additionally, as these athletes mature through adolescence, and with increased duration of play, they lose hip internal rotation and their FABER distance test increases - both of which are also associated with CAM-type FAI. These findings place their hip “at risk” for further labral injury, articular cartilage injury and potential early onset hip arthritis.
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