Skip to main content
SpringerLink
Log in

Hip Pathology That Can Cause Groin Pain in Athletes: Diagnosis and Management

  • Chapter
  • First Online:
Sports Hernia and Athletic Pubalgia

  • 1441 Accesses

Abstract

Identifying the source of hip pain in the athlete is challenging and a systematic approach should start with the joint itself. Intraarticular hip pathology is a common source of groin pain and frequently underlies or causes secondary conditions that limit the athlete. Potential intraarticular conditions include labral tears, chondral damage, loose bodies, femoroacetabular impingement (FAI), hip dysplasia, and hip instability. A thorough history and physical examination helps to establish the joint as the cause of groin pain. An imaging algorithm that includes plain radiographs, magnetic resonance imaging (MRI), and computed tomography (CT) may be used to confirm the diagnosis and plan intervention. CT with three-dimensional reconstructions provides excellent demonstration of the osseous morphology of the joint. Intraarticular injection of local anesthetic is invaluable to verifying the joint as the cause of pain. Central to the evaluation of an intraarticular problem is the morphology of the joint. Abnormal femoroacetabular morphology creates a mismatch between ball and socket that leads to impingement, damage to the labrum and articular cartilage, and accelerated wear. The evolution of hip arthroscopy has fueled an improved understanding of the etiology of hip dysfunction and provided new methods to treat hip pathology.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 99.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Burnett RSJ, Della Rocca GJ, Prather H, Curry M, Maloney WJ, Clohisy JC. Clinical presentation of patients with tears of the acetabular labrum. J Bone Joint Surg Am. 2006;88(7):1448–57. doi:10.2106/JBJS.D.02806.

    Article  PubMed  Google Scholar 

  2. Gerhardt MB, Romero AA, Silvers HJ, Harris DJ, Watanabe D, Mandelbaum BR. The prevalence of radiographic hip abnormalities in elite soccer players. Am J Sports Med. 2012;40(3):584–8. doi:10.1177/0363546511432711.

    Article  PubMed  Google Scholar 

  3. Register B, Pennock AT, Ho CP, Strickland CD, Lawand A, Philippon MJ. Prevalence of abnormal hip findings in asymptomatic participants: a prospective, blinded study. Am J Sports Med. 2012;40(12):2720–4. doi:10.1177/0363546512462124.

    Article  PubMed  Google Scholar 

  4. Smith-Petersen MN. The classic: treatment of malum coxae senilis, old slipped upper femoral epiphysis, intrapelvic protrusion of the acetabulum, and coxa plana by means of acetabuloplasty. Clin Orthop Relat Res. 2009;467(3):608–15. doi:10.1007/s11999-008-0670-0.

    Article  PubMed  Google Scholar 

  5. Ganz R, Parvizi J, Beck M, Leunig M, Nötzli H, Siebenrock KA. Femoroacetabular impingement: a cause for osteoarthritis of the hip. Clin Orthop Relat Res. 2003;417:112–20. doi:10.1097/01.blo.0000096804.78689.c2.

    PubMed  Google Scholar 

  6. Smith-Petersen M. Treatment of malum coxae senilis, old slipped upper femoral epiphysis, intrapelvic protrusion of the acetabulum, and coxa plana by means of acetabuloplasty. J Bone Joint Surg. 1936;18(4):869–80. Available at http://jbjs.org/article.aspx?articleID=8620. Accessed 5 June 2013.

    Google Scholar 

  7. Wasielewski RC. The hip. In: Callaghan JJ, Rosenberg AG, Rubash HE, editors. The adult hip, vol. 2. Philadelphia: Lippincott Williams & Wilkins; 2007. p. 51–65.

    Google Scholar 

  8. Köhnlein W, Ganz R, Impellizzeri FM, Leunig M. Acetabular morphology: implications for joint-preserving surgery. Clin Orthop Relat Res. 2009;467(3):682–91. doi:10.1007/s11999-008-0682-9.

    Article  PubMed  Google Scholar 

  9. Boykin RE, Anz AW, Bushnell BD, Kocher MS, Stubbs AJ, Philippon MJ. Hip instability. J Am Acad Orthop Surg. 2011;19(6):340–9. Available at http://www.ncbi.nlm.nih.gov/pubmed/21628645. Accessed 27 Jan 2013.

    PubMed  Google Scholar 

  10. Kelly BT, Williams RJ, Philippon MJ. Hip arthroscopy: current indications, treatment options, and management issues. Am J Sports Med. 2003;31(6):1020–37. Available at http://www.ncbi.nlm.nih.gov/pubmed/14623676.

    PubMed  Google Scholar 

  11. Bowman KF, Fox J, Sekiya JK. A clinically relevant review of hip biomechanics. Arthroscopy. 2010;26(8):1118–29. doi:10.1016/j.arthro.2010.01.027.

    Article  PubMed  Google Scholar 

  12. Shindle MK, Ranawat AS, Kelly BT. Diagnosis and management of traumatic and atraumatic hip instability in the athletic patient. Clin Sports Med. 2006;25(2):309–26. doi:10.1016/j.csm.2005.12.003. ix–x.

    Article  PubMed  Google Scholar 

  13. Crawford MJ, Dy CJ, Alexander JW, et al. The 2007 Frank Stinchfield Award. The biomechanics of the hip labrum and the stability of the hip. Clin Orthop Relat Res. 2007;465(465):16–22. doi:10.1097/BLO.0b013e31815b181f.

    PubMed  Google Scholar 

  14. Kim YT, Azuma H. The nerve endings of the acetabular labrum. Clin Orthop Relat Res. 1995;320:176–81. Available at http://www.ncbi.nlm.nih.gov/pubmed/ 7586824. Accessed 11 June 2013.

    PubMed  Google Scholar 

  15. Jacoby L, Yi-Meng Y, Kocher MS. Hip problems and arthroscopy: adolescent hip as it relates to sports. Clin Sports Med. 2011;30(2):435–51. doi:10.1016/j.csm.2011.01.003.

    Article  PubMed  Google Scholar 

  16. Bedi A, Kelly BT. Femoroacetabular impingement. J Bone Joint Surg Am. 2013;95(1):82–92. doi:10.2106/JBJS.K.01219.

    Article  PubMed  Google Scholar 

  17. Bedi A, Dolan M, Leunig M, Kelly BT. Static and dynamic mechanical causes of hip pain. Arthroscopy. 2011;27(2):235–51. doi:10.1016/j.arthro.2010.07.022.

    Article  PubMed  Google Scholar 

  18. Epstein DM, McHugh M, Yorio M, Neri B. Intra-articular hip injuries in National Hockey League players: a descriptive epidemiological study. Am J Sports Med. 2013;41(2):343–8. doi:10.1177/0363546512467612.

    Article  PubMed  Google Scholar 

  19. Jonasson P, Halldin K, Karlsson J, et al. Prevalence of joint-related pain in the extremities and spine in five groups of top athletes. Knee Surg Sports Traumatol Arthrosc. 2011;19(9):1540–6. doi:10.1007/s00167-011-1539-4.

    Article  PubMed  Google Scholar 

  20. Byrd JWT, Jones KS. Traumatic rupture of the ligamentum teres as a source of hip pain. Arthroscopy. 2004;20(4):385–91. doi:10.1016/j.arthro.2004.01.025.

    Article  PubMed  Google Scholar 

  21. Philippon MJ, Kuppersmith DA, Wolff AB, Briggs KK. Arthroscopic findings following traumatic hip dislocation in 14 professional athletes. Arthroscopy. 2009;25(2):169–74. doi:10.1016/j.arthro.2008.09.013.

    Article  PubMed  Google Scholar 

  22. Tibor LM, Sekiya JK. Differential diagnosis of pain around the hip joint. Arthroscopy. 2008;24(12):1407–21. doi:10.1016/j.arthro.2008.06.019.

    Article  PubMed  Google Scholar 

  23. McSweeney SE, Naraghi A, Salonen D, Theodoropoulos J, White LM. Hip and groin pain in the professional athlete. Can Assoc Radiol J. 2012;63(2):87–99. doi:10.1016/j.carj.2010.11.001.

    Article  PubMed  Google Scholar 

  24. Sierra RJ, Trousdale RT, Ganz R, Leunig M. Hip disease in the young, active patient: evaluation and nonarthroplasty surgical options. J Am Acad Orthop Surg. 2008;16(12):689–703. Available at http://www.ncbi.nlm.nih.gov/pubmed/19056918. Accessed 14 Apr 2013.

    PubMed  Google Scholar 

  25. Byrd JWT. Patient selection and physical examination. In: Byrd JWT, editor. Operative hip arthroscopy. 3rd ed. New York: Springer; 2013. p. 7–33. doi:10.1007/978-1-4419-7925-4.

    Chapter  Google Scholar 

  26. Byrd JWT. Diagnostic accuracy of clinical assessment, magnetic resonance imaging, magnetic resonance arthrography, and intra-articular injection in hip arthroscopy patients. Am J Sports Med. 2004;32(7): 1668–74. doi:10.1177/0363546504266480.

    Article  PubMed  Google Scholar 

  27. Byrd JWT. Hip arthroscopy. J Am Acad Orthop Surg. 2006;14(7):433–44. Available at http://www.ncbi.nlm.nih.gov/pubmed/22989716.

    PubMed  Google Scholar 

  28. Byrd JWT. Femoroacetabular impingement in athletes, part 1: cause and assessment. Sports Health. 2010;2(4):321–33. doi:10.1177/1941738110368392.

    PubMed Central  PubMed  Google Scholar 

  29. Byrd JWT, Jones KS. Arthroscopic femoroplasty in the management of cam-type femoroacetabular impingement. Clin Orthop Relat Res. 2009;467(3):739–46. doi:10.1007/s11999-008-0659-8.

    Article  PubMed  Google Scholar 

  30. Martin HD, Kelly BT, Leunig M, et al. The pattern and technique in the clinical evaluation of the adult hip: the common physical examination tests of hip specialists. Arthroscopy. 2010;26(2):161–72. doi:10.1016/j.arthro.2009.07.015.

    Article  PubMed  Google Scholar 

  31. Martin HD. Clinical examination and imaging of the hip. In: Byrd JT, Guanche CA, editors. AANA advanced arthroscopy: the hip. Philadelphia: Elsevier Inc.; 2010. p. 3–30.

    Google Scholar 

  32. Clohisy JC, Carlisle JC, Beaulé PE, et al. A systematic approach to the plain radiographic evaluation of the young adult hip. J Bone Joint Surg Am. 2008;90 Suppl 4:47–66. doi:10.2106/JBJS.H.00756.

    Article  PubMed  Google Scholar 

  33. Patel K, Wallace R, Busconi BD. Radiology. Clin Sports Med. 2011;30(2):239–83. doi:10.1016/j.csm.2010.12.004.

    Article  PubMed  Google Scholar 

  34. Leunig M, Beaulé PE, Ganz R. The concept of femoroacetabular impingement: current status and future perspectives. Clin Orthop Relat Res. 2009;467(3):616–22. doi:10.1007/s11999-008-0646-0.

    Article  PubMed  Google Scholar 

  35. Bedi A, Dolan M, Hetsroni I, et al. Surgical treatment of femoroacetabular impingement improves hip kinematics: a computer-assisted model. Am J Sports Med. 2011;39(Suppl):43S–9. doi:10.1177/0363546511414635.

    Article  PubMed  Google Scholar 

  36. McCarthy JC, Lee J-A. History of hip arthroscopy: challenges and opportunities. Clin Sports Med. 2011;30(2):217–24. doi:10.1016/j.csm.2010.12.001.

    Article  PubMed  Google Scholar 

  37. Byrd JWT, Jones KS. Hip arthroscopy in athletes: 10-year follow-up. Am J Sports Med. 2009;37(11):2140–3. doi:10.1177/0363546509337705.

    Article  PubMed  Google Scholar 

  38. Byrd JWT, Jones KS. Prospective analysis of hip arthroscopy with 10-year followup. Clin Orthop Relat Res. 2010;468(3):741–6. doi:10.1007/s11999-009-0841-7.

    Article  PubMed  Google Scholar 

  39. Colvin AC, Harrast J, Harner C. Trends in hip arthroscopy. J Bone Joint Surg Am. 2012;94(4):e23. doi:10.2106/JBJS.J.01886.

    Article  PubMed  Google Scholar 

  40. Byrd JW, Jones KS. Hip arthroscopy in athletes. Clin Sports Med. 2001;20(4):749–61. Available at http://www.ncbi.nlm.nih.gov/pubmed/19684291.

    Article  CAS  PubMed  Google Scholar 

  41. Nord RM, Meislin RJ. Hip arthroscopy in adults. Bull NYU Hosp Jt Dis. 2010;68(2):97–102. Available at http://www.ncbi.nlm.nih.gov/pubmed/20632984.

    PubMed  Google Scholar 

  42. Lynch TS, Terry MA, Bedi A, Kelly BT. Hip arthroscopic surgery: patient evaluation, current indications, and outcomes. Am J Sports Med. 2013;41(5):1174–89.

    Article  PubMed  Google Scholar 

  43. Philippon MJ, Weiss DR, Kuppersmith DA, Briggs KK, Hay CJ. Arthroscopic labral repair and treatment of femoroacetabular impingement in professional hockey players. Am J Sports Med. 2010;38(1):99–104. doi:10.1177/0363546509346393.

    Article  PubMed  Google Scholar 

  44. Matsuda DK, Carlisle JC, Arthurs SC, Wierks CH, Philippon MJ. Comparative systematic review of the open dislocation, mini-open, and arthroscopic surgeries for femoroacetabular impingement. Arthroscopy. 2011;27(2):252–69. doi:10.1016/j.arthro.2010.09.011.

    Article  PubMed  Google Scholar 

  45. Stevens MS, Legay DA, Glazebrook MA, Amirault D. The evidence for hip arthroscopy: grading the current indications. Arthroscopy. 2010;26(10):1370–83. doi:10.1016/j.arthro.2010.07.016.

    Article  PubMed  Google Scholar 

  46. Clarke MT, Arora A, Villar RN. Hip arthroscopy: complications in 1054 cases. Clin Orthop Relat Res. 2003;406:84–8. doi:10.1097/01.blo.0000043048. 84315.af.

    Article  PubMed  Google Scholar 

  47. Hammoud S, Bedi A, Magennis E, Meyers WC, Kelly BT. High incidence of athletic pubalgia symptoms in professional athletes with symptomatic femoroacetabular impingement. Arthroscopy. 2012;28(10):1388–95. doi:10.1016/j.arthro.2012.02.024.

    Article  PubMed  Google Scholar 

  48. Birmingham PM, Kelly BT, Jacobs R, McGrady L, Wang M. The effect of dynamic femoroacetabular impingement on pubic symphysis motion: a cadaveric study. Am J Sports Med. 2012;40(5):1113–8. doi:10.1177/0363546512437723.

    Article  PubMed  Google Scholar 

  49. Beck M, Kalhor M, Leunig M, Ganz R. Hip morphology influences the pattern of damage to the acetabular cartilage: femoroacetabular impingement as a cause of early osteoarthritis of the hip. J Bone Joint Surg Br. 2005;87(7):1012–8. doi:10.1302/0301-620X.87B7.15203.

    Article  CAS  PubMed  Google Scholar 

  50. Clohisy JC, Baca G, Beaulé PE, et al. Descriptive epidemiology of femoroacetabular impingement: a North American cohort of patients undergoing surgery. Am J Sports Med. 2013;41(6):1348–56. doi:10.1177/0363546513488861.

    Article  PubMed  Google Scholar 

  51. Philippon MJ, Souza BGS. Femoroacetabular impingement: pincer. In: Byrd JWT, Guanche CA, editors. AANA advanced arthroscopy: the hip. Philadelphia: Elsevier Inc.; 2010. p. 79–89.

    Google Scholar 

  52. Larson CM, Kelly BT, Stone RM. Making a case for anterior inferior iliac spine/subspine hip impingement: three representative case reports and proposed concept. Arthroscopy. 2011;27(12):1732–7. doi:10.1016/j.arthro.2011.10.004.

    Article  PubMed  Google Scholar 

  53. Pollard TCB, Villar RN, Norton MR, et al. Genetic influences in the aetiology of femoroacetabular impingement: a sibling study. J Bone Joint Surg Br. 2010;92(2):209–16. doi:10.1302/0301-620X.92B2.22850.

    Article  CAS  PubMed  Google Scholar 

  54. Reynolds D, Lucas J, Klaue K. Retroversion of the acetabulum. A cause of hip pain. J Bone Joint Surg Br. 1999;81(2):281–8. Available at http://www.ncbi.nlm.nih.gov/pubmed/10204935. Accessed 8 June 2013.

    Article  CAS  PubMed  Google Scholar 

  55. Tannast M, Siebenrock KA, Anderson SE. Femoroacetabular impingement: radiographic diagnosis—what the radiologist should know. AJR Am J Roentgenol. 2007;188(6):1540–52.

    Article  PubMed  Google Scholar 

  56. Kalberer F, Sierra RJ, Madan SS, Ganz R, Leunig M. Ischial spine projection into the pelvis: a new sign for acetabular retroversion. Clin Orthop Relat Res. 2008;466(3):677–83. doi:10.1007/s11999-007-0058-6.

    Article  PubMed  Google Scholar 

  57. Byrd JWT. Cam-type femoroacetabular impingement. In: Carlos A. Guanche, J.W. Thomas Byrd AANA advanced arthroscopy: the hip, vol. 2. Philadelphia: Elsevier Inc.; 2010. p. 65–78. doi:10.1177/1941738110368392.

  58. Siebenrock KA, Behning A, Mamisch TC, Schwab JM. Growth plate alteration precedes cam-type deformity in elite basketball players. Clin Orthop Relat Res. 2013;471(4):1084–91. doi:10.1007/s11999-012-2740-6.

    Article  PubMed  Google Scholar 

  59. Nepple JJ, Brophy RH, Matava MJ, Wright RW, Clohisy JC. Radiographic findings of femoroacetabular impingement in National Football League Combine athletes undergoing radiographs for previous hip or groin pain. Arthroscopy. 2012;28(10):1396–403. doi:10.1016/j.arthro.2012.03.005.

    Article  PubMed  Google Scholar 

  60. Larson CM, Pierce BR, Giveans MR. Treatment of athletes with symptomatic intra-articular hip pathology and athletic pubalgia/sports hernia: a case series. Arthroscopy. 2011;27(6):768–75. doi:10.1016/j.arthro.2011.01.018.

    Article  PubMed  Google Scholar 

  61. Anderson K, Strickland SM, Warren R. Hip and groin injuries in athletes. Am J Sports Med. 2001;29(4):521–33. Available at http://www.ncbi.nlm.nih.gov/pubmed/11476397. Accessed 14 Apr 2013.

    CAS  PubMed  Google Scholar 

  62. Naal FD, Miozzari HH, Wyss TF, Nötzli HP. Surgical hip dislocation for the treatment of femoroacetabular impingement in high-level athletes. Am J Sports Med. 2011;39(3):544–50. doi:10.1177/0363546510387263.

    Article  PubMed  Google Scholar 

  63. Harris JD, Erickson BJ, Bush-Joseph CA, Nho SJ. Treatment of femoroacetabular impingement: a systematic review. Curr Rev Musculoskelet Med. 2013;6(3):207–18. doi:10.1007/s12178-013-9172-0.

    Article  PubMed  Google Scholar 

  64. Laude F, Sariali E, Nogier A. Femoroacetabular impingement treatment using arthroscopy and anterior approach. Clin Orthop Relat Res. 2009;467(3):747–52. doi:10.1007/s11999-008-0656-y.

    Article  PubMed  Google Scholar 

  65. Bedi A, Zaltz I, De La Torre K, Kelly BT. Radiographic comparison of surgical hip dislocation and hip arthroscopy for treatment of cam deformity in femoroacetabular impingement. Am J Sports Med. 2011;39(Suppl):20S–8. doi:10.1177/0363546511412734.

    Article  PubMed  Google Scholar 

  66. Nho SJ, Magennis EM, Singh CK, Kelly BT. Outcomes after the arthroscopic treatment of femoroacetabular impingement in a mixed group of high-level athletes. Am J Sports Med. 2011;39(Suppl):14S–9. doi:10.1177/0363546511401900.

    Article  PubMed  Google Scholar 

  67. Byrd JWT, Jones KS. Arthroscopic management of femoroacetabular impingement in athletes. Am J Sports Med. 2011;39(Suppl):7S–13. doi:10.1177/0363546511404144.

    Article  PubMed  Google Scholar 

  68. Feeley BT, Powell JW, Muller MS, Barnes RP, Warren RF, Kelly BT. Hip injuries and labral tears in the national football league. Am J Sports Med. 2008;36(11):2187–95. doi:10.1177/0363546508319898.

    Article  PubMed  Google Scholar 

  69. Kelly BT, Weiland DE, Schenker ML, Philippon MJ. Arthroscopic labral repair in the hip: surgical technique and review of the literature. Arthroscopy. 2005;21(12):1496–504. doi:10.1016/j.arthro. 2005.08.013.

    Article  PubMed  Google Scholar 

  70. Wenger DE, Kendell KR, Miner MR, Trousdale RT. Acetabular labral tears rarely occur in the absence of bony abnormalities. Clin Orthop Relat Res. 2004;426(426):145–50. doi:10.1097/01.blo. 0000136903.01368.20.

    Article  PubMed  Google Scholar 

  71. Mintz DN, Hooper T, Connell D, Buly R, Padgett DE, Potter HG. Magnetic resonance imaging of the hip: detection of labral and chondral abnormalities using noncontrast imaging. Arthroscopy. 2005;21(4):385–93. doi:10.1016/j.arthro.2004.12.011.

    Article  PubMed  Google Scholar 

  72. Toomayan GA, Holman WR, Major NM, Kozlowicz SM, Vail TP. Sensitivity of MR arthrography in the evaluation of acetabular labral tears. AJR Am J Roentgenol. 2006;186(2):449–53. doi:10.2214/AJR.04.1809.

    Article  PubMed  Google Scholar 

  73. Freedman BA, Potter BK, Dinauer PA, Giuliani JR, Kuklo TR, Murphy KP. Prognostic value of magnetic resonance arthrography for Czerny stage II and III acetabular labral tears. Arthroscopy. 2006;22(7):742–7. doi:10.1016/j.arthro.2006.03.014.

    Article  PubMed  Google Scholar 

  74. Sundberg TP, Toomayan GA, Major NM. Evaluation of the acetabular labrum at 3.0-T MR imaging compared with 1.5-T MR arthrography: preliminary experience. Radiology. 2006;238(2):706–11.

    Article  PubMed  Google Scholar 

  75. Byrd JW. Labral lesions: an elusive source of hip pain case reports and literature review. Arthroscopy. 1996;12(5):603–12. Available at http://www.ncbi.nlm.nih.gov/pubmed/8902136. Accessed 12 June 2013.

    Article  CAS  PubMed  Google Scholar 

  76. Kelly BT, Shapiro GS, Digiovanni CW, Buly RL, Potter HG, Hannafin JA. Vascularity of the hip labrum: a cadaveric investigation. Arthroscopy. 2005;21(1):3–11. doi:10.1016/j.arthro.2004.09.016.

    Article  PubMed  Google Scholar 

  77. Meftah M, Rodriguez JA, Panagopoulos G, Alexiades MM. Long-term results of arthroscopic labral debridement: predictors of outcomes. Orthopedics. 2011;34(10):e588–92. doi:10.3928/01477447-20110826-04.

    PubMed  Google Scholar 

  78. Potter BK, Freedman BA, Andersen RC, Bojescul JA, Kuklo TR, Murphy KP. Correlation of short form-36 and disability status with outcomes of arthroscopic acetabular labral debridement. Am J Sports Med. 2005;33(6):864–70. doi:10.1177/0363546504270567.

    Article  PubMed  Google Scholar 

  79. Schilders E, Dimitrakopoulou A, Bismil Q, Marchant P, Cooke C. Arthroscopic treatment of labral tears in femoroacetabular impingement: a comparative study of refixation and resection with a minimum two-year follow-up. J Bone Joint Surg Br. 2011;93(8):1027–32. doi:10.1302/0301-620X.93B8.26065.

    Article  CAS  PubMed  Google Scholar 

  80. Larson CM, Giveans MR, Stone RM. Arthroscopic debridement versus refixation of the acetabular labrum associated with femoroacetabular impingement: mean 3.5-year follow-up. Am J Sports Med. 2012;40(5):1015–21.

    Article  PubMed  Google Scholar 

  81. Krych AJ, Thompson M, Knutson Z, Scoon J, Coleman SH. Arthroscopic labral repair versus selective labral debridement in female patients with femoroacetabular impingement: a prospective randomized study. Arthroscopy. 2013;29(1):46–53. doi:10.1016/j.arthro.2012.07.011.

    Article  PubMed  Google Scholar 

  82. Byrd JW. Lateral impact injury. A source of occult hip pathology. Clin Sports Med. 2001;20(4):801–15. Available at http://www.ncbi.nlm.nih.gov/pubmed/11675888. Accessed 14 June 2013.

    Article  CAS  PubMed  Google Scholar 

  83. Fujii M, Nakashima Y, Jingushi S, et al. Intraarticular findings in symptomatic developmental dysplasia of the hip. J Pediatr Orthop. 2009;29(1):9–13. doi:10.1097/BPO.0b013e318190a0be.

    Article  PubMed  Google Scholar 

  84. Keeney JA, Peelle MW, Jackson J, Rubin D, Maloney WJ, Clohisy JC. Magnetic resonance arthrography versus arthroscopy in the evaluation of articular hip pathology. Clin Orthop Relat Res. 2004;429:163–9. Available at http://www.ncbi.nlm.nih.gov/pubmed/15577482. Accessed 14 June 2013.

    Article  PubMed  Google Scholar 

  85. Konan S, Rayan F, Meermans G, Witt J, Haddad FS. Validation of the classification system for acetabular chondral lesions identified at arthroscopy in patients with femoroacetabular impingement. J Bone Joint Surg Br. 2011;93(3):332–6. doi:10.1302/0301-620X.93B3.25322.

    Article  CAS  PubMed  Google Scholar 

  86. Ilizaliturri VM, Byrd JWT, Sampson TG, et al. A geographic zone method to describe intra-articular pathology in hip arthroscopy: cadaveric study and preliminary report. Arthroscopy. 2008;24(5):534–9. doi:10.1016/j.arthro.2007.11.019.

    Article  PubMed  Google Scholar 

  87. Jordan MA, Van Thiel GS, Chahal J, Nho SJ. Operative treatment of chondral defects in the hip joint: a systematic review. Curr Rev Musculoskelet Med. 2012;5(3):244–53. doi:10.1007/s12178-012-9134-y.

    Article  PubMed Central  PubMed  Google Scholar 

  88. Foulk D, Mullis B. Hip dislocation: evaluation and management. J Am Acad Orthop Surg. 2010;18(4):199–209. Available at https://jaaos.org/content/18/4/199.full. Accessed 17 June 2013.

    PubMed  Google Scholar 

  89. Moorman CT, Warren RF, Hershman EB, et al. Traumatic posterior hip subluxation in American football. J Bone Joint Surg Am. 2003;85-A(7):1190–6. Available at http://www.ncbi.nlm.nih.gov/pubmed/12851341. Accessed 17 June 2013.

    PubMed  Google Scholar 

  90. Mullis BH, Dahners LE. Hip arthroscopy to remove loose bodies after traumatic dislocation. J Orthop Trauma. 2006;20(1):22–6. Available at http://www.ncbi.nlm.nih.gov/pubmed/16424806. Accessed 17 June 2013.

    Article  PubMed  Google Scholar 

  91. Shu B, Safran MR. Hip instability: anatomic and clinical considerations of traumatic and atraumatic instability. Clin Sports Med. 2011;30(2):349–67. doi:10.1016/j.csm.2010.12.008.

    Article  PubMed  Google Scholar 

  92. Beighton P, Horan F. Orthopaedic aspects of the Ehlers–Danlos syndrome. J Bone Joint Surg Br. 1969;51(3):444–53. Available at http://www.ncbi.nlm.nih.gov/pubmed/5820785. Accessed 10 Mar 2013.

    CAS  PubMed  Google Scholar 

  93. Smith MV, Sekiya JK. Hip instability. Sports Med Arthrosc. 2010;18(2):108–12. doi:10.1097/JSA. 0b013e3181de0fff.

    Article  PubMed  Google Scholar 

  94. Byrd JWT, Jones KS. Hip arthroscopy in the presence of dysplasia. Arthroscopy. 2003;19(10):1055–60. doi:10.1016/j.arthro.2003.10.010.

    Article  PubMed  Google Scholar 

  95. Domb BG, Philippon MJ, Giordano BD. Arthroscopic capsulotomy, capsular repair, and capsular plication of the hip: relation to atraumatic instability. Arthroscopy. 2013;29(1):162–73. doi:10.1016/j.arthro.2012.04.057.

    Article  PubMed  Google Scholar 

  96. Jackson TJ, Watson J, Lareau JM, Domb BG. Periacetabular osteotomy and arthroscopic labral repair after failed hip arthroscopy due to iatrogenic aggravation of hip dysplasia. Knee Surg Sports Traumatol Arthrosc. 2013. doi:10.1007/s00167-013-2540-x

  97. Bogunovic L, Gottlieb M, Pashos G, Baca G, Clohisy JC. Why do hip arthroscopy procedures fail? Clin Orthop Relat Res. 2013;471(8):2523–9. doi:10.1007/s11999-013-3015-6.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, University of Virginia Health System, 400 Ray C. Hunt Drive, Suite 330, Charlottesville, VA, 22903, USA

    F. Winston Gwathmey Jr.

  2. University of Virginia Athletics, Charlottesville, VA, USA

    F. Winston Gwathmey Jr.

  3. Nashville Sports Medicine and Orthopaedic Center, Nashville, TN, USA

    J. W. Thomas Byrd

Authors
  1. F. Winston Gwathmey Jr.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J. W. Thomas Byrd
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to F. Winston Gwathmey Jr. .

Editor information

Editors and Affiliations

  1. Alfred R. Shands Professor of Orthopedic Surgery, Head Orthopedic Team Physician, Director, Sports Medicine Fellowship Program, University of Virginia School of Medicine, Charlottesville, Virginia, USA

    David R. Diduch

  2. Team Surgeon, St. Louis Blues, Professor of Surgery, Department of Surgery, Section of Minimally Invasive Surgery, Washington University School of Medicine, St. Louis, Missouri, USA

    L. Michael Brunt

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer Science+Business Media New York

About this chapter

Cite this chapter

Gwathmey, F.W., Byrd, J.W.T. (2014). Hip Pathology That Can Cause Groin Pain in Athletes: Diagnosis and Management. In: Diduch, D., Brunt, L. (eds) Sports Hernia and Athletic Pubalgia. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-7421-1_4

Download citation

  • DOI: https://doi.org/10.1007/978-1-4899-7421-1_4

  • Published:

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4899-7420-4

  • Online ISBN: 978-1-4899-7421-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation