Kapron Ashley L, Peters Christopher L, Aoki Stephen K, Beckmann James T, Erickson Jill A, Anderson Mike B, Pelt Christopher E
Department of Orthopaedics, University of Utah, Salt Lake City, Utah, USA.
Department of Orthopaedics, University of Utah, Salt Lake City, Utah, USA
Am J Sports Med. 2015 Jun;43(6):1324-30. doi: 10.1177/0363546515576908. Epub 2015 Mar 31.
Structural deformities of the hip, including femoroacetabular impingement (FAI) and acetabular dysplasia, often limit athletic activity. Previous studies have reported an increased prevalence of radiographic cam FAI in male athletes, but data on the prevalence of structural hip deformities in female athletes are lacking.
(1) To quantify the prevalence of radiographic FAI deformities and acetabular dysplasia in female collegiate athletes from 3 sports: volleyball, soccer, and track and field. (2) To identify possible relationships between radiographic measures of hip morphologic characteristics and physical examination findings.
Cross-sectional study; Level of evidence, 3.
Anteroposterior (AP) pelvis and frog-leg lateral radiographs were obtained from 63 female athletes participating in Division I collegiate volleyball, soccer, and track and field. Lateral center edge angle (LCEA) and acetabular index were measured on AP films. Alpha angle and head-neck offset were measured on frog-leg lateral films. Pain during the supine impingement examination and hip rotation at 90° of flexion were recorded. Random-effects linear regression was used for group comparisons and correlation analyses to account for the lack of independence of observations made on left and right hips.
Radiographic cam deformity (alpha angle >50° and/or head-neck offset <8 mm) was found in 48% (61/126) of hips. Radiographic pincer deformity (LCEA >40°) was noted in only 1% (1/126) of hips. No hips had radiographic mixed FAI (at least 1 of the 2 cam criteria and LCEA >40°). Twenty-one percent (26/126) of hips had an LCEA <20°, indicative of acetabular dysplasia, and an additional 46% (58/126) of hips had borderline dysplasia (LCEA ≥20° and ≤25°). Track and field athletes had significantly increased alpha angles (48.2° ± 7.1°) compared with the soccer players (40.0° ± 6.8°; P < .001) and volleyball players (39.1° ± 5.9°; P < .001). There was no significant difference in the LCEA (all P > .914) or the prevalence of dysplasia (LCEA <20°) between teams (all P > .551). There were no significant correlations between the radiographic measures and internal rotation (all P > .077). There were no significant differences (all P > .089) in radiographic measures between hips that were painful (n = 26) during the impingement examination and those that were not.
These female athletes had a lower prevalence of radiographic FAI deformities compared with previously reported values for male athletes and a higher prevalence of acetabular dysplasia than reported for women in previous studies.
髋关节的结构畸形，包括股骨髋臼撞击症（FAI）和髋臼发育不良，常常限制体育活动。既往研究报道男性运动员中影像学上凸轮型FAI的患病率增加，但关于女性运动员结构髋关节畸形患病率的数据尚缺乏。
（1）量化来自排球、足球和田径3项运动的女性大学生运动员中影像学FAI畸形和髋臼发育不良的患病率。（2）确定髋关节形态学特征的影像学测量与体格检查结果之间的可能关系。
横断面研究；证据等级，3级。
对63名参加美国大学体育协会（NCAA）一级联赛的排球、足球和田径项目的女性运动员拍摄骨盆前后位（AP）和蛙式侧位X线片。在AP片上测量外侧中心边缘角（LCEA）和髋臼指数。在蛙式侧位片上测量α角和头颈偏移。记录仰卧位撞击试验时的疼痛情况以及屈曲90°时的髋关节旋转情况。采用随机效应线性回归进行组间比较和相关性分析，以考虑左右髋观察结果缺乏独立性的情况。
48%（61/126）的髋关节存在影像学凸轮畸形（α角>50°和/或头颈偏移<8 mm）。仅1%（1/126）的髋关节存在影像学钳夹畸形（LCEA>40°）。没有髋关节存在影像学混合型FAI（2项凸轮标准中至少1项且LCEA>40°）。21%（26/126）的髋关节LCEA<20°，提示髋臼发育不良，另外46%（58/126）的髋关节存在临界发育不良（LCEA≥20°且≤25°）。与足球运动员（40.0°±6.8°；P<.001）和排球运动员（39.1°±5.9°；P<.001）相比，田径运动员的α角显著增大（48.2°±7.1°）。各队之间LCEA（所有P>.914）或发育不良患病率（LCEA<20°）无显著差异（所有P>.551）。影像学测量与内旋之间无显著相关性（所有P>.077）。在撞击试验时疼痛的髋关节（n=26）与无疼痛的髋关节之间，影像学测量无显著差异（所有P>.089）。
与既往报道男性运动员的值相比，这些女性运动员影像学FAI畸形的患病率较低，且髋臼发育不良的患病率高于既往研究报道的女性患病率。
