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Health See other Health Articles Title: Hip Disorder Common With Sports-Related Inguinal Hernias July 19, 2012 (Baltimore, Maryland) — Femoral acetabular impingement (FAI) is common among people with sports-related inguinal hernias, according to findings presented here at the American Orthopaedic Society for Sports Medicine (AOSSM) 2012 Annual Meeting. The study found evidence of FAI in 86% of patients who had undergone sports-related hernia repairs. "Our study shows a high prevalence of patients with treated sports hernias have FAI," said lead investigator Kostas Economopoulos, MD, from the Department of Orthopaedics at the University of Virginia, Richmond. "These results strengthen the idea that FAI and sports hernias may be related." Given the high prevalence, Dr. Economopoulos noted that "underlying FAI may be a cause of continued groin pain after sports hernia surgery and should be evaluated for patients who do not improve." Although sports hernias are a common cause of groin pain in athletes, not much is known about the source of the posterior wall weakness that leads to sports hernias. Several studies have shown an association between chronic groin pain and pathology, he noted. However, none of the earlier studies have shown the specific prevalence of FAI in patients with sports hernias. FAI is a hip condition involving a mechanical mismatch, Dr. Economopoulos explained. Either the femoral head, or ball, is out of round and/or the acetabulum in the socket extends over the ball too far, allowing for uneven wear inside the joint and leading to reduced range of motion and blocked internal rotation, which can lead to secondary damage to the joint. FAI also can change the mechanics of gait. The changes in pelvic biomechanics may lead to increased stresses across the groin, so it is possible that athletes with underlying FAI may be more likely to develop a sports hernia because of these stresses, he said. To determine how common FAI is in patients with sports hernias, the researchers performed a retrospective review of all patients at their institution who had undergone treatment for sports hernia between 1999 and 2011. They examined X-rays and magnetic resonance imaging or computed tomography scans of the patients' hips for radiologic signs of FAI. For patients at least 2 years out from surgery, they also did telephone follow-ups. Alpha angles greater than 55 degrees were considered positive for a Cam lesion and FAI, and center-edge angles greater than 45 degrees were considered positive for Pincer lesions, and therefore positive for FAI. The average alpha angle of a hip with associated sports hernia on the ipsilateral side was 75 degrees compared with the average alpha angle of hips without associated sports hernia on that side (61 degrees). The difference in the 2 angles was statistically significant. Among other findings, 67% of patients had isolated Cam lesions, 5% had isolated Pincer lesions, and 14% had combined Cam and Pincer lesions. Cam lesions were spotted in 75% of hips on the ipsilateral side of the hernia, whereas 46% of hips without associated hernia also had Cam lesions. The average alpha-angle of hips on the hernia side was 74.98 degrees; it was 60.98 degrees in hips with no associated hernia on the hernia side (P = .018). Researchers identified Pincer lesions in 16% of hips with associated hernias and 7% of hips without associated hernias. Average acetabular retroversion of hips with associated hernias was 13.17 degrees compared with 15.59 degrees in hips without hernias (P = .048) Session moderator J.W. Thomas Byrd, MD, an orthopedic surgeon with a private practice in Nashville, Tennessee, noted that a lot of questions still surround sports hernias and FAI. Sports hernias are not fully understood, and as for FAI, plenty of people have abnormally shaped hips, he told Medscape Medical News. Their X-rays will tell you they have classic FAI, but they are asymptomatic and do not necessarily develop problems. "We do a pretty good job explaining why people get into trouble with this," he said. "But what we can't explain is why some people are able to compensate so well and never develop problems. There's a lot of mystery surrounding both ends of this." Dr. Byrd said he thought the study was well done, although it is too soon to draw a strong conclusion that ties FAI to sports hernia. The study continues to make us aware of a possible connection, he said. Because of reduced rotational motion, perhaps there is a higher prevalence of FAI in people with sports hernias. "We're still trying to sort that out, because we know that there's a high prevalence of FAI even in just a normal athletic population," Dr. Byrd said. Poster Comment: A good reason to document how sports hernias occur and include information in school curriculum. Post Comment Private Reply Ignore Thread Top • Page Up • Full Thread • Page Down • Bottom/Latest Begin Trace Mode for Comment # 1.
#1. To: Tatarewicz (#0)
THANK YOU for this article! I've had Hip Pain for about 15 years now that all I could do was complain about. This info gives me a direction to follow up with my doctor. I caused severe Bi-Lateral Inguina Hernias to myself about 20 years ago setting Concrete Forms. Just recently I went to the Hospital that did the repair surgery and got a copy of the doctor notes from the surgery, because of the continuing pain. I suspected Mesh failure. What surprized me was that they'd had to use 4 mesh patches (2 inner, 2 outer) ON EACH SIDE. A comment was "massive damage". Anyway, I'd complained to my docyor over the years and he'd examine closely, but always said the repair mesh appeared sound. The Pain was mostly in my hips. I'm going to take this article to my first "bone doctor" appointment in Sept. (he's looking at treatment because of prednizone use since transplant). Maybe this article will get more scrutiny for the condition it notes. Thanks again!
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