The Demographics of High-level and Recreational Athletes With Intra-articular Hip Injury

Objectives: The pathoanatomy that causes femoroacetabular impingement (FAI) is common, but not everyone develops hip pain or arthrosis. Symptomatic FAI is likely due to a combination of anatomy and biomechanical demands, including sports participation. The primary purpose of this study was to determine demographic differences between high-level and recreational athletes undergoing hip arthroscopy. The secondary purpose of this study was to look at the demographics of high-level athletes grouped by sports with similar mechanical demands on the hip. We hypothesize that high-level and recreational athletes will differ by age, gender, and need for bilateral surgery. We also predict that demographics for high-level athletes will differ for sports with unique demands for hip kinematics. Methods: Using our hip preservation center registry, a retrospective review of prospectively collected data from patients undergoing hip arthroscopy between March 2010 and April 2012 was performed. Athletes were categorized as high-level (high school, collegiate, Olympic/international, or professional) or recreational. Subgroup analysis was performed for high-level athletes, looking at differences between contact, rotational running, impingement, overhead/asymmetric, endurance, and flexibility sports. Results: 288 high-level athletes and 334 recreational athletes were included. Being a high level athlete was associated with younger age (average age 20.2 vs 33.0, OR=0.69, P<0.001) and male gender (61.5% vs 53.6%, OR=1.75, P=0.03). The percentage of high-level athletes undergoing bilateral surgery was higher than for recreational athletes (28.4% vs 15.9%); however, this association was found to be confounded by age in multivariate analysis The most common sports for high-level athletes were soccer, hockey, and football. Athletes participating in rotational running sports were significantly younger than flexibility, contact, or impingement athletes. Similarly, endurance athletes were significantly younger than athletes in impingement sports. Conclusion: There are significant differences between high-level and recreational athletes that are likely to be important when counseling patients and reporting surgical outcomes. This study also provides important information about sports that provoke hip pain. Identifying biomechanical mechanisms that place young athletes at risk for hip injury enables anticipatory guidance and preventative strategies for these patients.