2015 ISAKOS Biennial Congress ePoster #822
Sport Specific Prevalence of Chondral Injuries in the Hip
Christiano A.C. Trindade, MD, Vail, CO UNITED STATES
Daniela Maglione, MD, Milan ITALY
Karen K. Briggs, MPH, MBS, Vail, CO UNITED STATES
Marc J. Philippon, MD, Vail, CO UNITED STATES
Steadman Philippon Research Institute, Vail, CO, USA
FDA Status Cleared
Summary: Hip chondral defects are common in athletes with FAI. Professional hockey and rotational sports had significantly higher risks of chondral injury when compared with the amateur players. Conversely, recreational runners have more risk than professionals. Some professional sports are at higher risk for major defects.
To determine the prevalence of chondral defects in the an active population of recreational and elite athlete population that were submitted to hip arthroscopy for femoroacetabular impingment (FAI).
A prospective data registry was queried for a consecutive series of 1037 (769 recreationals/amateurs and 268 professionals) with the diagnosis of FAI underwent hip arthroscopy by a single surgeon. The patients were between 18 to 50 years old. The exclusion criteria were: joint space of 2 mm or less, patients over the age of 50 and nonactive individuals. The following sports were selected: 1.Rotational sports- baseball, softball, discus throw, volleyball, tennis, golf 2.Repetitive non weightbearing – cycling, swimming 3.Running sports – marathon, triathlon, basketball 4.Snow sports – skiing, snowboard 5.Soccer 6.Football 7.Hockey 8.Dance
The professionals athletes were significantly younger when compared to the recreationals(28ys. vs 34ys. respectively;p=0.001). Chondral defects were seen in 822 of 1037 hips. In professional athletes, 86% had a chondral defect and in recreational 77% had a chondral defect (p=0.002). Grade III/IV defects were seen in 476 of 1037 hips. In professionals, 50% had grade III/IV defects and 45% in amateurs(p=0.155). For Grade IV defects, microfracture was done in 50 hips of 268 professionals and in 114 hips of 769 recreational athletes. (p=0.139). The prevalence of chondral defects is different by sport for both amateur (p=<0.001) and professional athletes (p=0.001). Significant differences between professional and recreational athletes were seen in hockey, rotational sports and running. Furthermore, there was significant difference in the prevalence of defects grade III/IV regarding sports performed by professional athletes(p=0.005).
Chondral lesions of the hip in professional athletes cause pain and worsening of their performance and can even lead to secundary osteoarthritis. We didn’t find studies in the literature correlating different sports and the prevalence of chondral lesions in the hip among professionals and recreationals athletes. The chondral lesions appeared in the professional and recreational athletes with different prevalence among sports. Significant differences between professional and recreational athletes was seen in hockey, rotational sports and running sports only. These data confirm that most professional and recreational athletes with the diagnosis of FAI at the time of arthroscopy present some degree of chondral defect. Interestingly, there are proportionally fewer professional running athletes with chondral lesions when compared to recreational ones. This can occur due to significantly higher age of these recreational athletes. When we consider injuries grade III/IV, the prevalence is different by sport just for the professional athletes. Some sports, such as football, soccer, hockey, are at higher risk of more severe defects, because they are considered collision sports. Snow sports and rotational sports, likewise, present falls at high speed and high speed rotation movements respectively, leading to high forces crossing the joint.
Hip chondral defects are common in athletes with FAI. Professional hockey and rotational sports had significantly higher risks of chondral injury when compared with the amateur players. Conversely, recreational runners have more risk than professionals. Some professional sports are at higher risk for major defects.