866 FO38 – Bony morphologies consistent with femoroacetabular impingement syndrome in young sport participants: considerations for prevention strategies

Background Repetitive stress to the femoral head during growth, as seen with certain youth sport participation, is associated with the development of cam morphology and potentially femoroacetabular impingement syndrome (FAIS). Youth male soccer, basketball, and ice hockey athletes have shown up to an 8-fold increased risk of developing cam morphology compared to male controls. Objective To examine FAIS-related hip morphologies in adolescent and young adult athletes. Design Systematic Review/Meta-analysis. Setting Studies examining FAIS prevalence in young athletes. Assessment of Risk Factors A literature search was conducted across five databases. Two reviewers independently screened each article based on predetermined inclusion/exclusion criteria. Data extraction and critical appraisal were carried out for each study using standardized methodology (Downs and Black). Summary statistics were compiled for studies reporting original data. A meta-regression was conducted to compare FAIS morphologies between adolescent and young adult athletes. Main Outcome Measurements (1) prevalence of FAIS morphologies in athletes; and (2) imaging and clinical assessment for diagnosis of FAIS. Results Forty-two studies including 985 adolescent (ages 12–19;16.5% female) and 2,276 young adult athletes (ages 19–31;20.1% female). Methods of diagnosis varied across studies. Clinical components for assessment (e.g., special tests, range of motion) and imaging parameters varied both within groups and across groups (adolescent and young adult). The prevalence of cam deformities by participant was larger in young adults athletes (young adult- 54%, 95% CI: 41, 66; adolescent- 28%, 95% CI: 14, 43; Qb(1)=6.60 p=0.01). Conclusions Prevalence of cam morphologies is higher in young adult athletes compared to adolescents. Few studies report findings in females and there is a lack of consistency in diagnostic criteria used. Future studies should aim to validate clinical assessment tools and imaging diagnosis parameters to develop and evaluate individually targeted prevention strategies including screening protocols and potential prevention-focused exercise-interventions.