title: The 2015 Frank Stinchfield Award: Radiographic Abnormalities Common in Senior Athletes With Well-functioning Hips but Not Associated With Osteoarthritis.
abstract: BACKGROUND
  It is not known whether morphological abnormalities of the hip are compatible with lifelong hip function and avoidance of osteoarthritis (OA). Our purpose was to investigate the prevalence of radiographic findings consistent with femoroacetabular impingement (FAI) and dysplasia (DDH) in senior athletes with well-functioning hips.
  
  
  OBJECTIVE
  (1) What is the prevalence of FAI and DDH in senior athletes with well-functioning hips? (2) Are radiographic findings of FAI and DDH associated with OA? (3) Is a history of longer duration or more intense activity associated with hip pathomorphology? (4) Were the modified Harris hip scores and the Hip Outcome Scores lower (legacy scales) in patients with evidence of hip pathomorphology than those without?
  
  
  METHODS
  Five hundred forty-seven individuals (55% men, 45% women; 1081 hips, 534 bilateral and 13 unilateral), mean age 67 years (SD 8 years), gave consent and qualified for this institutional review board-approved cross-sectional study of senior athletes. Hips were independently evaluated for radiographic signs of FAI, DDH, and OA. Additionally, a lifetime activities questionnaire and outcome instruments were used to assess pain and function. Hips that had previously undergone arthroplasty or fracture surgery were excluded.
  
  
  RESULTS
  Eighty-three percent (898 of 1081) of hips had radiographic abnormalities consistent with FAI, of which 67% (599 of 898) were cam-type FAI. Ten percent (103 of 1081) of hips had radiographic evidence for dysplasia. Radiographic findings of FAI were not predictive of OA after controlling for age and sex (odds ratio [OR], 1.79; 95% confidence interval [CI], 0.48-6.62; p = 0.390). Similarly, radiographic findings of DDH were not predictive of OA (OR, 1.48; 95% CI, 0.31-7.21; p = 0.62). Our data suggest an increased risk of FAI-type morphologies in athletes who participated in competitive sporting events during early adult years (OR, 1.49; 95% CI, 1.04-2.11; p = 0.020). Additionally, participants who reported lifetime participation in competitive sports were at an increased risk of OA compared with those who did not (OR, 1.75; 95% CI, 1.14-2.69; p = 0.007). There were no differences in outcome scores between athletes with and without morphologic abnormalities.
  
  
  CONCLUSIONS
  Radiographic findings consistent with FAI in these senior athletes were common and were not associated with the presence of OA. These data suggest that the need to screen for asymptomatic young athletes for radiographic evidence of FAI and DDH may not be necessary.
  
  
  METHODS
  Level III, prognostic study.
authors.affiliation: Department of Orthopaedic Surgery, University of Utah School of Medicine, 590 Wakara Way, Salt Lake City, UT, 84108, USA. lucas.anderson@hsc.utah.edu.
authors.forename: Lucas A
authors.initials: LA
authors.lastname: Anderson
authors.affiliation: Department of Orthopaedic Surgery, University of Utah School of Medicine, 590 Wakara Way, Salt Lake City, UT, 84108, USA.
authors.forename: Mike B
authors.initials: MB
authors.lastname: Anderson
authors.affiliation: Department of Orthopaedic Surgery, University of Utah School of Medicine, 590 Wakara Way, Salt Lake City, UT, 84108, USA.
authors.forename: Ashley
authors.initials: A
authors.lastname: Kapron
authors.affiliation: Department of Orthopaedic Surgery, University of Utah School of Medicine, 590 Wakara Way, Salt Lake City, UT, 84108, USA.
authors.forename: Stephen K
authors.initials: SK
authors.lastname: Aoki
authors.affiliation: Department of Orthopaedic Surgery, University of Utah School of Medicine, 590 Wakara Way, Salt Lake City, UT, 84108, USA.
authors.forename: Jill A
authors.initials: JA
authors.lastname: Erickson
authors.affiliation: Department of Orthopaedic Surgery, University of Utah School of Medicine, 590 Wakara Way, Salt Lake City, UT, 84108, USA.
authors.forename: Jesse
authors.initials: J
authors.lastname: Chrastil
authors.affiliation: Department of Orthopaedic Surgery, University of Utah School of Medicine, 590 Wakara Way, Salt Lake City, UT, 84108, USA.
authors.forename: Ramon
authors.initials: R
authors.lastname: Grijalva
authors.affiliation: Department of Orthopaedic Surgery, University of Utah School of Medicine, 590 Wakara Way, Salt Lake City, UT, 84108, USA.
authors.forename: Christopher
authors.initials: C
authors.lastname: Peters
mesh_terms: D000367:Age Factors; D000368:Aged; D056352:Athletes; D001363:Awards and Prizes; D001696:Biomechanical Phenomena; D003430:Cross-Sectional Studies; D005260:Female; D057925:Femoracetabular Impingement / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000503:physiopathology; D006617:Hip Dislocation / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000503:physiopathology; D006621:Hip Joint / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010147:Pain Measurement; D015995:Prevalence; D011859:Radiography; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013997:Time Factors