What is the Prevalence of Hip Intra-Articular Pathologies and Osteoarthritis in Active Athletes with Hip and Groin Pain Compared with Those Without? A Systematic Review and Meta-Analysis

  • Joshua J. Heerey
  • Joanne L. Kemp
  • Andrea B. Mosler
  • Denise M. Jones
  • Tania Pizzari
  • Mark J. Scholes
  • Rintje Agricola
  • Kay M. CrossleyEmail author
Systematic Review



In athletes, hip and groin pain is considered to be associated with hip intra-articular pathologies and hip osteoarthritis (OA). A greater understanding of the relationship between hip and groin pain and imaging findings is required.


Our objective was to undertake a systematic review and meta-analysis to determine the prevalence of hip intra-articular pathologies and hip OA in athletes with and without hip and groin pain.


Seven electronic databases were searched on 29 January 2018 for studies investigating the prevalence of hip intra-articular pathologies and hip OA using X-ray, magnetic resonance imaging, magnetic resonance arthrography or computed tomography. The search, study selection, quality appraisal and data extraction were performed by two independent reviewers. When studies were considered homogenous, meta-analysis was undertaken. A strength of evidence was given to pooled results.


Twenty studies reporting on the prevalence of hip intra-articular pathologies and hip OA in athletes were identified. Included studies were considered moderate to high risk of bias, with only three studies adjudged as low risk of bias. In asymptomatic athletes, limited evidence identified a labral tear prevalence of 54% per person and moderate evidence of 33% per hip. In symptomatic athletes, moderate evidence of a labral tear prevalence of 20% per hip was found. Moderate evidence of a cartilage defect prevalence of 10% per person was reported in asymptomatic athletes. In symptomatic athletes, cartilage defect prevalence was 7–40%. In asymptomatic athletes, the prevalence of hip OA was 0–17%, compared with 2% in symptomatic athletes.


The prevalence of hip intra-articular pathologies and hip OA in symptomatic and asymptomatic athletes is variable. Labral tears and cartilage defects appear to be seen often in athletes with and without pain. Hip OA is rarely seen in athletes either with or without hip and groin pain.

Study Registration

PROSPERO registration CRD42017082457.


Author contributions

JJH, JLK, ABM, DMJ, TP, MJS, RA and KMC were responsible for the creation and planning of the review. JJH and JLK were responsible for the search strategy utilised. JJH, JLK and MJS developed the strategy to evaluate study quality. JJH, ABM and KMC were involved in the data extraction process. JJH wrote the final manuscript, with all authors assisting in revising content.

Compliance with Ethical Standards

Conflict of interest

Joshua J. Heerey, Joanne L. Kemp, Andrea B. Mosler, Denise M. Jones, Tania Pizzari, Mark J. Scholes and Rintje Agricola declare they have no competing interests. Kay Crossley is a recipient of an NHMRC (National Health and Medical Research Council; Australia) Project Grant (GNT1088683), which provided funding to support this research.


No financial support was received for the conduct of this study or preparation of this manuscript.

Provenance and peer review

This review was not commissioned; the article was externally peer reviewed.

Supplementary material

40279_2019_1092_MOESM1_ESM.pdf (68 kb)
Supplementary material 1 (PDF 68 kb)
40279_2019_1092_MOESM2_ESM.pdf (122 kb)
Supplementary material 2 (PDF 123 kb)
40279_2019_1092_MOESM3_ESM.pdf (80 kb)
Supplementary material 3 (PDF 80 kb)


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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, College of Science, Health and EngineeringLa Trobe UniversityBundooraAustralia
  2. 2.Department of OrthopaedicsErasmus University Medical CenterRotterdamThe Netherlands

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