Chris Carter of Advanced Physicians, along with other respected and renowned members of the orthopedic community, have recently determined intra-articular lesions as a more likely cause of hip injuries and pain in younger NFL players than soft tissue injury, formerly the most attribute source of player hip injury and pain.
As background for the study, as determined by Chris Carter of Advanced Physicians and his colleagues, American football players are more susceptible to hip injuries than others due to the sport’s high level of player contact, increased biomechanical load and the anatomical strain players typically place on the hip joint. It has previously and often been thought, by physicians throughout the medical community, that these hip injuries were the result of soft tissue injury, though an increasing number of physicians, due to improved knowledge and the increased prevalence of medical imaging technology, or MRI, are attributing NFL players’ hip pain to intra-articular lesions.
The purpose of the study performed by Chris Carter of Advanced Physicians and his colleagues was to assess the presence and prevalence of these lesions in a group of younger and retired NFL players that have been analyzed and evaluated for persistent hip pain.
Chris Carter of Advanced Physicians and his peers performed a retrospective chart review of the Magnetic Resonance Imaging that was done on retired NFL players. The Imaging was evaluated at an orthopaedic clinic that specialized in persistent hip pain, and all MRIs were performed by the same independent radiologist professional at the same location. All in all, the study done by Chris Carter of Advanced Physicians and his medical colleagues included 62 individual hips, of which a total of 27 were evaluated with MRI technology and 35 were evaluated by with the use of an MRI Arthrogram. Each image was assessed for the presence of chondral lesions, labral tears, bone cysts, ligamentum tears, osteophytes, trochanteric bursitis, loose bodies and alpha angle. Each player’s particular demographics, including the number of seasons played and the position played, were taken into consideration.
The results published by Chris Carter of Advanced Physicians and his colleagues covered a total of 50 retired players that received impairment evaluations from February 2011 to December 2012. All evaluations performed assessed all symptomatic joints in players, and the average age of the players involved in this study was 33-years-old. Thirty-eight (76%) players, according to Chris Carter of Advanced Physicians and his peers, had hip complaints, and underwent a dedicated hip MRI. Twenty-four of the players involved experienced bilateral hip pain, leading to a total of 62 hips evaluated. According to the study results: “there were 55 (89%) labral tears, 61 (98%) chondral lesions, and 50 (81%) partial or complete LT tears identified on MRI. Additional findings included 3 (5%) hips with osteophytes, 9 (14.5%) with subchondral bone cysts, and 3 (5%) with paralabral cysts. None of the players were found to have trochanteric bursitis or loose bodies. Fifty-eight of 62 alpha angles could be measured, for a mean of 59° (range, 39°-77°). The majority of players were defensive players (63%), while the remainder were offensive players (34%) and 1 special teams player. Position breakdown was as follows: 29% were defensive backs, 16% played the defensive line, 18% were linebackers, 13% were fullbacks, 11% were wide receivers, 5% played the offensive line, and the remaining 8% were kickers, running backs, and quarterbacks.”
The conclusions of Chris Carter of Advanced Physicians and his professional peers was that a high incidence of intra-articular pathologic lesions of the hip were found in the players under evaluation, and that further research is necessary to further determine incidence, as well as the outcomes of injury treatment.