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Child and Teen Athletes at Risk for Hip Osteoarthritis


The risk of developing hip osteoarthritis is probably the last thing on the minds of child and teen athletes. However, a new study suggests that participation in vigorous sports like basketball can result in abnormal bone development that may result in early osteoarthritis of the hip.

Regular sports activities increase osteoarthritis risk

In the mid 1990s, an overview of a report commissioned by the Carnegie Corporation on organized sports among children opened with the words “Although sports are not viewed as a panacea for society’s ills, sports participation that emphasizes skill-building and socially acceptable responses to personal relationships has prove to be a popular aid in the education of youth.”

Potential health risks are also associated with sports participation by young people, as has been shown in a number of studies. One of the most recent was conducted by Dr. Klaus Siebenrock, of the University of Bern, Switzerland, and colleagues, who evaluated the prevalence of a cam-type hip deformity of the proximal femur in young male athletes and its relationship to hip development, hip pain, and osteoarthritis of the hip.

The femur, or thigh bone, is the longest and largest bone in the body. It is located just above the knee joint and forms part of the hip joint. The femur has four protuberances, or knob-like protrusions, that become fully integrated with the femur in late adolescence/early adulthood.

The study group consisted of 37 males ages 9 to 25 years who were recruited from a professional basketball club in Germany, and 38 age-matched males from middle, high, and medical schools. Depending on their age, the players typically participated in at least three training sessions and/or one to eight games per week.

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All the study participants underwent an evaluation, including medical history, a physical examination of the hips that included range of motion and an anterior impingement test (which checks for pain), and magnetic resonance imaging (MRI) of each hip.

Overall, the researchers reported that the athletes were ten times more likely to have impaired hip movement and function than were the controls. They observed evidence of deformity of the femur head among the athletes who had played since they were eight years old.

This deformity resulted in abnormal contact between the femur and hip socket and subsequent reduction in hip rotation and movement. These changes were more evident after closure of the femoral growth plate, which occurs during late adolescence.

More specifically, 11 (15%) of the 72 hips in the athletes were painful and showed deformity. Among controls, internal rotation of the hip averaged 30.1 degrees, but only 18.9 degrees in the athletes. The maximum value of the alpha angle averaged 60.5 degrees among the athletes and 47.4 degrees in the controls. Basically, alpha angle is a measurement used to identify abnormality in the hip.

The authors concluded their data suggested that a “cam-type deformity is in part a developmental deformity,” and that its appearance in young adults “may be triggered by environmental factors such as high-level sports activity during childhood and around the time of closure of the capital growth plate.” They suggest these femoral changes among child and teen athletes “are a key component in the elevated incidence of hip osteoarthritis observed in athletes.”

Seefeldt VD, Ewing ME. Youth sports in America: an overview. 1997
Siebenrock KA et al. Clinical Orthopaedics and Related Research 2011; doi: 10.1007/s11999-011-1945-4