Increasing alpha angle is predictive of athletic-related "hip" and "groin" pain in collegiate National Football League prospects.
OBJECTIVE
The first purpose was to evaluate radiographic pathomorphology/abnormalities in a cohort of high-level collegiate football players screened with hip radiographs. The second purpose was to define the radiographic predictors of athletic-related "hip" and "groin" symptoms in this cohort of high-level athletes.


METHODS
The study population included all male collegiate football players undergoing evaluation and hip radiography at the National Football League (NFL) Scouting Combine in 2009 and 2010. All radiographs were evaluated with a detailed evaluation for hip pathomorphology. Symptoms were recorded as symptomatic or asymptomatic with respect to athletic-related groin/hip pain for comparative purposes.


RESULTS
There were 125 players (239 hips) who had hip radiographs and were included in the final cohort. Ninety percent of players (87% of hips) in this cohort had at least 1 finding consistent with cam-type and/or pincer-type femoroacetabular impingement (FAI). There were 75 hips in the symptomatic group and 164 hips in the asymptomatic group. Although the symptomatic group had a greater prevalence of cam-type FAI (P = .009), combined-type FAI (P < .001), and osteitis pubis (P = .014), increasing alpha angle (larger cam deformities) was the only independent predictor of athletic-related groin pain (P = .01). There was no correlation, however, between FAI and body mass index (P = .659), player position (P = .166), or whether a player was drafted by an NFL team (P = .430).


CONCLUSIONS
Radiographic signs of FAI were frequently seen in collegiate NFL prospects who were screened with hip radiographs. Although patients with radiographic evidence of osteitis pubis, cam- and combined-type FAI, and larger cam deformities showed a statistically higher prevalence of symptoms, increasing alpha angle (larger cam deformity) was the only independent predictor of athletic-related hip/groin pain.


METHODS
Level IV, therapeutic case series.
Minnesota Orthopedic Sports Medicine Institute at Twin Cities Orthopedics, Edina, Minnesota, USA. chrislarson@tcomn.com
Christopher M
CM
Larson
Robby S
RS
Sikka
Matthew C
MC
Sardelli
J W Thomas
JW
Byrd
Bryan T
BT
Kelly
Rahul K
RK
Jain
M Russell
MR
Giveans
D001847:Bone Diseases / Q000000981:diagnostic imaging*; D057925:Femoracetabular Impingement / Q000000981:diagnostic imaging*; D005538:Football; D006119:Groin; D006615:Hip; D006801:Humans; D007592:Joint Diseases / Q000000981:diagnostic imaging; D008297:Male; D010146:Pain / Q000000981:diagnostic imaging* / Q000209:etiology; D011859:Radiography; D014495:Universities