Most sports medicine physician research is concentrated on the knee and shoulder, and some research is performed about the athletic elbow and foot and ankle. Still in its infancy is the sports medicine physician's interest in and knowledge about hip injuries and mechanics in the athlete. This may be because of the infrequency of hip injuries in athletes, the difficulty of identification of hip pathology, or the relatively limited options of treatment for the hip. Research focusing on hip maladies is lagging behind that of other areas in sports medicine, although with the advent of hip arthroscopy and knowledge of treatable hip injuries in athletes, sports medicine clinicians are becoming more interested in the hip. Unfortunately, much of the literature about the hip is based on anatomy and arthritic processes about the hip and little is written about the hip in athletes. Therefore, it is timely to publish this issue of Sports Medicine and Arthroscopy Review to compile the current knowledge and state-of-the-art information about the hip in athletes to update the sports medicine physician.
In the first article, Dr. Matthew Matava and associates from Washington University in St. Louis set the table by performing a comprehensive review of the anatomy and synthesizing what is present in the literature about the biomechanics of the hip and its role in the athlete. Dr. Hollis Potter and associates at the Hospital for Special Surgery review imaging modalities in relation to several maladies about the hip in athletes with many clear and excellent examples. Dr. Answorth Allen and associates at the Hospital for Special Surgery review the history, pathology, treatment, and complications of hip dislocations and traumatic subluxations. These latter authors also discuss their vast experience with this problem in athletes.
Acetabular specialists Dr. Joel Matta and Dr. Tania Ferguson present a case of hip impingement, which is being recognized as an increasingly common cause of hip pain. Dr. Matta and Dr. Ferguson review the presentation and treatment of this increasingly recognized problem. Hip impingement has been discussed in the trauma society arena, but has not been discussed in the sports medicine literature, and knowledge of this diagnosis may clue in the physician to a source of pain or etiology of labral pathology to allow for appropriate management of the patient's problem.
Dr. Russ Huffman and I review the literature on the anatomy, pathophysiology, diagnosis, and treatment of labral tears, one of the increasingly recognized sources of hip pain in athletes. Dr. J. Thomas Byrd of Nashville provides an excellent review of the technique and role of arthroscopy in diagnosis and treatment of pathology about the hip in athletes. Dr. Ned Amendola from the University of Iowa reviews the diagnosis and treatment of the many bony sources of pain and injury about the hip in athletes, including femoral neck stress fractures, avulsion injuries in the skeletally immature, and osteitis pubis. Lastly, Dr. Mark Hutchinson and his associate from the University of Illinois, Chicago review the pathology, diagnosis and treatment of the many soft tissue lesions about the hip in athletes that may produce pain. These include hip pointers, the different sources of bursitis, the two sources of snapping hip syndrome, and the less common entities of gluteus medius syndrome and piriformis syndrome.
Great care and effort have been put forth by the authors in compiling this edition of Sports Medicine and Arthroscopy Review because there is a paucity of literature regarding hip injuries in athletes. As increasing attention is paid to the hip in athletes, this edition of Sports Medicine and Arthroscopy Review provides the most current, state-of-the-art information to the clinician. The end result is what I, and the contributing authors, hope to be the definitive review of hip injuries in athletes.