The Development of the Non-Perfect Hip in Young Athletes

This thesis contains research about normal values of hip muscle strength, hip range of motion and hip and groin related symptoms of professional football and field hockey players. In addition, research is conducted on the development of the hip joint and the association between an abnormal hip shape (cam morphology, classified by alpha angle >60 degrees) and limited range of motion, symptoms, other radiological parameters and hip osteoarthriti

The prevalence of cam and pincer morphology and its association with development of hip osteoarthritis

Our understanding of femoroacetabular impingement syndrome is slowly improving. The number of studies on all aspects (etiology, prevalence, pathophysiology, natural history, treatment, and preventive measures) of femoroacetabular impingement syndrome has grown exponentially over the past few years. This commentary provides the latest updates on the prevalence of cam and pincer hip morphology and its relationship with development of hip osteoarthritis (OA). Cam and pincer morphology is highly prevalent in the general population and in this paper is presented for different subgroups based on age, sex, ethnicity, and athletic activity. Methodological issues in determining prevalence of abnormal hip morphology are also discussed. Cam morphology has been associated with development of hip OA, but the association between pincer morphology and hip OA is much less clear. Results from reviewed studies, as well as remaining gaps in literature on this topic, are critically discussed and put into perspective for the clinician

The relationship between cam morphology and hip and groin symptoms and signs in young male football players

Background: Conflicting and limited high-quality prospective data are available on the associations between cam morphology and hip and groin symptoms and range of motion (ROM). Objectives: This cross-sectional cohort study investigated associations between cam morphology presence, size and duration and symptoms and ROM. Methods: Academy male football players (n = 49, 17-24 years) were included. Standardized antero-posterior pelvic and frog-leg lateral radiographs were obtained at baseline, 2.5- and 5-year follow-up. The femoral head-neck junction was quantified by: Visual score. Cam morphology (flattening or prominence), large cam (prominence). Alpha angle.

Normal values for hip muscle strength and range of motion in elite, sub-elite and amateur male field hockey players

Objectives: To determine normal values for hip strength and range of motion (ROM) of elite, sub-elite and amateur male field hockey players and to examine the effect of age, leg dominance, playing position, playing level and non-time-loss groin pain on hip strength and ROM. Design: Cross-sectional study. Setting: Physical testing took place at field hockey clubs. Participants: Male field hockey players competing in the three highest Dutch field hockey leagues (n ¼ 104). Main out

The genetic epidemiology of joint shape and the development of osteoarthritis

Congruent, low-friction relative movement between the articulating elements of a synovial joint is an essential pre-requisite for sustained, efficient, function. Where disorders of joint formation or maintenance exist, mechanical overloading and osteoarthritis (OA) follow. The heritable component of OA accounts for ~ 50% of susceptible risk. Although almost 100 genetic risk loci for OA have now been identified, and the epidemiological relationship between joint development, joint shape and osteoarthritis is well established, we still have only a limited understanding of the contribution that genetic variation makes to joint shape and how this modulates OA risk. In this article, a brief overview of synovial joint development and its genetic regulation is followed by a review of current knowledge on the genetic epidemiology of established joint shape disorders and common shape variation. A summary of current genetic epidemiology of OA is also given, together with current evidence on the genetic overlap between shape variation and OA. Finally, the established genetic risk loci for both joint shape and osteoarthritis are discussed

Patient-reported outcome measures for hip-related pain: A review of the available evidence and a consensus statement from the International Hip-related Pain Research Network, Zurich 2018

Hip-related pain is a well-recognised complaint among active young and middle-aged active adults. People experiencing hip-related disorders commonly report pain and reduced functional capacity, including difficulties in executing activities of daily living. Patient-reported outcome measures (PROMs) are essential to accurately examine and compare the effects of different treatments on disability in those with hip pain. In November 2018, 38 researchers and clinicians working in the field of hip-related pain met in Zurich, Switzerland for the first International Hip-related Pain Research Network meeting. Prior to the meeting, evidence summaries were developed relating to four prioritised themes. This paper discusses the available evidence and consensus process from which recommendations were made regarding the appropriate use of PROMs to assess disability in young and middle-aged active adults with hip-related pain. Our process to gain consensus had five steps: (1) systematic review of systematic reviews; (2) preliminary discussion within the working group; (3) update of the more recent high-quality systematic review and examination of the psychometric properties of PROMs according to established guidelines; (4) formulation of the recommendations considering the limitations of the PROMs derived from the examination of their quality; and (5

Correction to: Clinical and radiological hip parameters do not precede, but develop simultaneously with cam morp

Due to typographic mistakes made by the editorial office, several corrections have been made. The original article has been corrected

Hip and groin pain in male field hockey players: Prevalence, incidence and associations with patient reported outcome scores and hip muscle strength

Objectives: Investigate point prevalence (second half season 2018–2019) and incidence (season 2017–2018 and first half season 2018–2019) of non-time-loss and time-loss hip/groin pain in male field hockey players. Secondary aims were to study associations between: current/previous hip/groin pain and hip muscle strength, patient reported outcome measures (PROM) and hip muscle strength, and previous hip/groin pain and PROMs. Additionally we studied normal values for the PROMs (Hip and Groin Outcome Score (HAGOS)). Design: Cross-sectional study. Setting: Testing at field hockey clubs. Participants: 100 male field hockey players (elite, sub-elite and amateur). Main outcome measures: Point prevalence and incidence of hip/groin pain, strength: eccentric adduction and abduction, adductor squeeze, HAGOS. Results: Hip/groin pain point prevalence was 17% (time-loss: 6%) and incidence was 36% (time-loss: 12%). Presence of current or previous hip/groin and lower HAGOS-values were not associated with lower hip muscle strength. Previous hip/groin pain was associated with a significant lower HAGOS-values in all domains, except for the ‘participation in physical activities’ domain. Conclusions: Hip/groin pain is common in field hockey. One fifth of players have hip/groin pain and one third had pain in the previous season. Previous hip/groin pain was associated with worse ongoing patient reported outcomes in most domains

Cam morphology in young male football players mostly develops before proximal femoral growth plate closure: A prospective study with 5-year follow-up

Objectives: Cam morphology is not completely understood. The aim of this study was threefold: (1) to investigate if cam morphology development is associated with growth plate status; (2) to examine whether cam morphology continues to develop after growth plate closure; and (3) to qualitatively describe cam morphology development over 5-year follow-up. Methods: Academy