title: Ethnic Differences in Bony Hip Morphology in a Cohort of 445 Professional Male Soccer Players.
abstract: Participation in high-impact athletic activities has recently been associated with a higher prevalence of cam deformity. Bony hip morphology has also emerged as an important factor in the development of hip osteoarthritis. However, it is unknown whether bony morphology differs between ethnicities in athletes participating in high-impact sports.
  
  
  
  To investigate whether the prevalence of specific bony hip morphological abnormalities differed between professional male soccer players of diverse ethnic backgrounds.
  
  
  
  Cross-sectional study; Level of evidence, 3.
  
  
  
  Professional male soccer players from an entire league attending preparticipation screening were invited to participate in this study. Ethnicity was registered, and standardized radiographs of anteroposterior pelvic and Dunn views were obtained. Cam and pincer deformity, and acetabular dysplasia were quantified using the alpha angle, triangular index, and lateral center-edge angle (LCEA). Regression analyses with generalized estimating equations were used to determine prevalence differences in bony hip morphology.
  
  
  
  A total of 445 male soccer players (890 hips; mean age ± SD, 25 ± 4.9 years) participated in the study, representing the following ethnic groups: Arabic (59%), black (24%), Persian (7%), white (6%), East Asian (2%), and other (2%). The prevalence of cam deformity (alpha angle >60°) ranged from 57.5% to 71.7% across 4 of the groups, but East Asians had a significantly lower prevalence (18.8%; P ≤ .032). A large cam deformity (alpha angle >78°) was more prevalent in white (33.3%) compared with black soccer players (17.8%; P = .041) and was absent in East Asian players. Pincer deformity (LCEA >40°) was uncommon (3%) in all ethnicities. The prevalence of acetabular dysplasia (LCEA <20°) ranged from 8.0% to 16.7%, apart from the white group, in which prevalence was only 1.9% (P = .03).
  
  
  
  The prevalence of a cam deformity and acetabular dysplasia differed between ethnicities in this cohort of professional male soccer players. These findings suggest that there may be ethnic differences in both acetabular morphology and femoral bony response to athletic load.
authors: Rehabilitation Department, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar andrea.mosler@aspetar.com.|School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Queensland, Australia.|School of Allied Health, La Trobe University, Melbourne, Victoria, Australia.
authors: Andrea B
authors: AB
authors: Mosler
authors: School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Queensland, Australia.|School of Allied Health, La Trobe University, Melbourne, Victoria, Australia.
authors: Kay M
authors: KM
authors: Crossley
authors: Department of Orthopaedics, Erasmus University Medical Centre, Rotterdam, the Netherlands.
authors: Jan H
authors: JH
authors: Waarsing
authors: Radiology Department, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar.
authors: Nabil
authors: N
authors: Jomaah
authors: Sports Groin Pain Centre, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar.
authors: Adam
authors: A
authors: Weir
authors: Sports Groin Pain Centre, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar.|Sports Orthopedic Research Center-Copenhagen, Arthroscopic Center, Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Denmark.
authors: Per
authors: P
authors: Hölmich
authors: Department of Orthopaedics, Erasmus University Medical Centre, Rotterdam, the Netherlands.|Sports Groin Pain Centre, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar.
authors: Rintje
authors: R
authors: Agricola
mesh_terms: D000328:Adult; D056352:Athletes; D003430:Cross-Sectional Studies; D057925:Femoracetabular Impingement / Q000000981:diagnostic imaging / Q000208:ethnology* / Q000473:pathology; D006801:Humans; D008297:Male; D010384:Pelvic Bones / Q000002:abnormalities* / Q000000981:diagnostic imaging; D015995:Prevalence; D012916:Soccer; D055815:Young Adult
keywords: cam deformity; dysplasia; femoroacetabular impingement; pincer; sports