Prevalence of femoroacetabular impingement syndrome and related hip morphologies, and its developmental dose-response relationship in professional female football players: a multicentre cohort study (PROFE).

OBJECTIVES

To determine the prevalence of femoroacetabular impingement syndrome, primary cam morphology, pincer morphology and acetabular dysplasia in professional female football players. The secondary aim was to explore a dose-response relationship between sport frequency, age of menarche, and the development of femoroacetabular impingement syndrome and primary cam morphology.

DESIGN

Cross-sectional.

METHODS

Questionnaires obtained information on presence of groin pain and current/previous sport frequencies. Physical examination included internal hip rotation and the flexion-adduction-internal rotation test. Anteroposterior and frog-leg lateral radiographic views were used to measure alpha angles and lateral centre-edge angles. Femoroacetabular impingement syndrome was defined by presence of groin pain, a positive flexion-adduction-internal rotation test, and primary cam morphology (alpha angles 60°) or pincer morphology (centre-edge angles ≥ 40°). Acetabular dysplasia was defined as lateral centre-edge angles < 20° and borderline dysplasia as lateral centre-edge angles 20-25°. Dose-response associations were analysed by logistic regression using generalised estimating equations.

RESULTS

One hundred professional female football players (mean (±standard deviation) age = 20.4 (±3.7) years) participated. Per person prevalence of femoroacetabular impingement syndrome was 3%. Per person prevalences for hip morphologies were: primary cam morphology 49%, pincer morphology 10%, borderline dysplasia 11% and dysplasia 1%. There was no dose-response relationship between previous sport frequency or age of menarche, and prevalence of femoroacetabular impingement syndrome and primary cam morphology.

CONCLUSIONS

In professional female football players, the prevalence of femoroacetabular impingement syndrome is low, whilst the prevalence of primary cam morphology is relatively high. The aetiology of femoroacetabular impingement syndrome and primary cam morphology in female football players may not be solely driven by high load activity during skeletal maturation but is likely multifactorial and may differ from that in males.