EP1.7 Prospective Evaluation of Sport Activity and the Development of Femoroacetabular Impingement in the Adolescent Hip (PREVIEW): Results from the International, Multi-Centred, Prospective Cohort Study

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ID: 331344
2026
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Abstract
Abstract Background Femoroacetabular impingement (FAI), a well-recognized risk factor to hip osteoarthritis, has an estimated prevalence ranging from 15-17% in asymptomatic young adults, to 95% in competitive athletes. High-intensity repetitive athletic activity during adolescence may contribute to FAI morphology development, particularly in sports involving deep flexion and pivoting movements. The purpose of this prospective cohort study was to determine if sport specialization at the moderate-to-vigorous physical activity (MVPA) level is associated with the development of symptomatic and asymptomatic FAI in adolescents compared to non-sport specialists and those that do not play sports. Methods Asymptomatic participants aged 12-14 years were recruited and stratified by sport specialization status defined as MVPA levels ≥180 minutes/week for at least 8 months per year. Participants underwent an MRI of the dominant hip, a physical examination, and completed Hip Outcome Score (HOS) and Pediatric Quality of Life (PedsQL) questionnaires at baseline and 24 months. Activity was monitored using a wrist-worn tracker and activity log every 3 months. Radiographic FAI was determined by an independent adjudication committee using pre-specified MRI criteria. Logistic regression adjusted for sex and body mass index (BMI) was used to compare FAI incidence between groups. Results Of 194 participants (mean age 13.0, standard deviation (SD) = 0.7 years, 53.6% male), 39 met the criteria for a sport specialist and 122 were non-sport specialists. The overall incidence of radiographic FAI at 24 months was 47.9%. There was no significant difference in FAI development between sport specialists and non-sport specialists (51.4% vs 46.7%; odds ratio (OR) 0.78, 95% confidence interval (CI) 0.29-2.11, p=0.620). Sport specialists reported significantly higher hip pain over the 24-month follow-up period (17.9% vs 4.1%; OR 5.17, 95% CI 1.53-17.41, p=0.008). Symptomatic radiographic FAI was associated with statistically significantly higher odds of cartilage injury (OR 5.33, 95% CI 1.17-24.30, p=0.031). Conclusion Sport specialization did not appear to impact radiographic FAI development in adolescent athletes at the 2-year follow-up. However, sport specialists demonstrated significantly higher rates of hip pain, and symptomatic FAI was associated with increased cartilage injuries.
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Authors Preview investigators, Olufemi Rolland Ayeni
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Journal Journal of hip preservation surgery
Year 2026
DOI
10.1093/jhps/hnag043.191
URL
https://doi.org/10.1093/jhps/hnag043.191
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