Athletic Hip Injuries and Capsular Laxity
Section snippets
Clinical Diagnosis
Hip injuries in the athlete often are diagnosed as extra-articular muscle strains or soft tissue contusions. However, within the past decade, various intra-articular pathologies have been identified and treated arthroscopically in the athlete (Table 1).3 To appropriately direct treatment, a full history and clinical and radiological workup is required in all athletes to differentiate the site of pathology.
Pain is the most commonly reported symptom in athletes with hip injuries.3 It is a
Anatomy
The joint capsule and the ligaments provide a thick sleeve surrounding the hip. The iliofemoral ligament dominates the anterior capsule. It is approximately 12- to 14-mm thick and is shaped like an inverted “Y.” This ligament provides resistance to hip extension beyond neutral and resists external rotation. The pubofemoral ligament reinforces the inferior and anterior capsule. It resists extension and abduction. The posterior surface of the capsule is reinforced by the ischiofemoral ligament in
Capsular Laxity
Instability in the hip joint is rarely an issue. Because of the deep recess of the acetabular socket and the strong ligamentous support, the hip joint is inherently stable. However, any deviation from “normal” osseous anatomy places excessive force on the adjacent soft tissues during movement.
Hip instability can be of traumatic or atraumatic origin and often is difficult to diagnose. Traumatic instability is the result of dislocation or subluxation of the femoral head.6 Most athletic hip
Hip Arthroscopy in Athletes
Injuries requiring hip arthroscopy cover a wide range of sports and hip pathologies (Table 2).3 Athletes subject their hip joints to extraphysiological forces that can approach 5 times their body weight. Athletic activities, such as running and jumping, twisting, and quickly cutting across the field, can lead to a variety of acute and chronic hip pathologies.
Discussion
Elite athletes are subjected to extreme forces and ranges of motion in their everyday sport activity. The hip joint is highly affected by the additional stresses, and the athlete is prone to developing hip injuries. Injury mechanisms may be acute and traumatic, or repetitive from overuse. Hip injuries in athletes that do not resolve over the course of a 4-6 week time period should prompt further investigation into possible intra-articular damage.
In the relatively short time period that hip
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Cited by (65)
Hip Pain Increases With Age and Experience Level in Adult Karate Athletes: A Statewide Survey Study
2022, Arthroscopy, Sports Medicine, and RehabilitationCitation Excerpt :It is likely that of the 27 subjects with hip pain yet to seek medical consultation, a similarly high number of patients with FAI and labral tears would be identified. Philippon and Schenker9 reported a 40% prevalence of FAI (2 of 5) in symptomatic martial artists at the elite level, in their study. The present data suggest elite-level karate athletes have a prevalence of FAI and labral tears at 22.2% and 33.3%, respectively.
Hip Injuries in Overhead Athletes
2019, Operative Techniques in Sports MedicineEffects of hip joint transverse plane range of motion with a modeled effusion and capsular tear: A cadaveric study
2017, Clinical BiomechanicsCitation Excerpt :Moorman et al. (2003) described a classic triad of hemarthrosis, posterior acetabular lip fracture or labral tear, and iliofemoral ligament disruption in a series of dislocations in American football players demonstrating the importance of these structures to hip stability. Atraumatic instability from conditions of generalized laxity such as Marfan and Ehlers-Danlos syndromes, as well as microtrauma with repetitive hip twisting in certain sports, can lead to attenuation of the anterior capsular ligaments, labral injury, chondral injury, and even recurrent microinstability (Bedi et al., 2011; Philippon and Schenker, 2005; Shindle et al., 2006; Shu and Safrab, 2011; Torry et al., 2006). The number of hip arthroscopies performed has increased dramatically in recent years (Montgomery et al., 2013).