title: Intra-articular hip injuries in national hockey league players: a descriptive epidemiological study.
abstract: BACKGROUND
  Intra-articular hip injuries are thought to be common in professional ice hockey; however, injury incidence and missed playing time have not been previously documented. Furthermore, it is not known if injury incidence differs between player positions.
  
  
  OBJECTIVE
  The incidence of symptomatic intra-articular hip injuries in goaltenders is higher than that of other position players.
  
  
  METHODS
  Cohort study; Level of evidence, 3.
  
  
  METHODS
  A database containing the injury surveillance of National Hockey League (NHL) players from the years 2006 to 2010 was used to identify athletes who had sustained a hip or groin injury. From this database, players diagnosed with an intra-articular hip injury were identified. The incidence of intra-articular hip injuries per 1000 player-hours played and per 1000 player-game appearances was compared between goaltenders, defensemen, and forwards.
  
  
  RESULTS
  Ninety-four hip injuries, accounting for 10.6% (94/890) of all hip and groin injuries, were identified as intra-articular in nature during the time of the surveillance. Most injuries occurred during the regular season (71.2%; 67/94) and during a game (44.6%; 42/94). Players who sustained intra-articular hip injuries had significantly higher total man-games missed compared with those with all other groin injuries (mean ± SD, 8.5 ± 23.0 vs. 1.2 ± 4.2 missed games; P = .0001). The most frequent intra-articular hip diagnoses made in this cohort were hip labral tear (69.1%), followed by hip osteoarthritis (13.8%), hip loose body (6.3%), and hip femoroacetabular impingement (5.3%). The incidence of intra-articular hip injuries per 1000 player-game hours was not different between goaltenders (1.97) and other on-ice players (defensemen, 1.43; forwards, 1.38) (relative risk [RR], 1.40; 95% CI, 0.86-1.40; P = .22). However, injuries per 1000 player-game appearances were significantly higher in goaltenders (1.84) compared with other on-ice players (defensemen, 0.47; forwards, 0.34) (RR, 4.78; 95% CI, 2.94-7.76; P < .0001).
  
  
  CONCLUSIONS
  Hip labral tears are the most frequently encountered intra-articular hip injury in the NHL player and can lead to an average of 8 man-games missed per injury. Goaltenders were not at higher risk when measuring injuries per hours played but were at significantly greater risk of an intra-articular hip injury than other on-ice players (RR, 4.7) when measured per game played.
authors.affiliation: American Sports Medicine Institute, Birmingham, Alabama, USA. drdeps@gmail.com
authors.forename: David M
authors.initials: DM
authors.lastname: Epstein
authors.forename: Malachy
authors.initials: M
authors.lastname: McHugh
authors.forename: Michael
authors.initials: M
authors.lastname: Yorio
authors.forename: Brian
authors.initials: B
authors.lastname: Neri
mesh_terms: D001265:Athletic Injuries / Q000453:epidemiology*; D025981:Hip Injuries / Q000453:epidemiology*; D006621:Hip Joint; D006688:Hockey / Q000293:injuries* / Q000706:statistics & numerical data; D006801:Humans