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Grimaldi Forum Monaco, Monte Carlo, Monaco 7–9 April 2011
Screening of asymptomatic elite youth hockey players: clinical and MRI exam
  1. M J Philippon,
  2. R F LaPrade,
  3. K K Briggs,
  4. J D Stull
  1. Steadman Philippon Research Institute, Vail, Colorado, USA

Abstract

Background Ice hockey players are reportedly at increased risk to suffer hip injuries. This may be due to repetitive hip positions during the ice hockey skate stride.

Objective To determine if specific tests used during a screening program can identify youth hockey players who are at risk of acetabular labral tears due to femoroacetabular impingement (FAI).

Design Prospective screening study.

Setting Clinical centre screened elite youth hockey players.

Participants 20 asymptomatic male (average age of 17.6 SD=0.5) ice hockey players who had signed IRB approved consent.

Assessment of risk factors Participants underwent impingement testing, Flexion Abduction External Rotation (FABER) test, and range of motion and hip strength assessment prior to an MRI (3T) to determine hip alpha angle (AA) and labral pathology.

Main outcome measurements Positive clinical findings of impingement correlate with the presence of labral pathology and high AA.

Results 14 players had a positive clinical exam (+impingement test or+FABER test or decreased hip internal rotation). Players with a positive clinical exam had a significantly higher AA compared to those with no positive signs (68° vs 61°; p<0.025). Players with a positive clinical exam were 12.5 times (95% CI 1.1 to 143) more likely to have an AA 65° or greater. 12 of the 14 participants with a positive clinical exam also had partial acetabular labral tears.

Conclusion With this screening protocol, we were able to identify those patients with higher AA, which are considered at high risk. These players also demonstrated labral tears on MRI. We recommend that hip screening utilizing the impingement test, FABER test, and assessment of hip internal rotation be conducted as the initial screening of athletes with hip pain to assess for symptomatic FAI.

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