Radiographic findings in restrained hip joints associated with ACL rupture

Although decreased hip range of motion has been detected in many soccer players with noncontact anterior cruciate ligament (ACL), it is not clear whether it is associated with bone spurs, capsular soft tissue stiffness or both. Our aim was to investigate abnormal radiographic findings in soccer players with limited hip range of motion and noncontact ACL injury. Fifty consecutive male soccer players with restricted hip range of motion and noncontact ACL injury were subjected to radiographic examination to identify bone changes that could be associated with decreased hip range of motion. Of 50 patients, 56% revealed abnormal radiographic findings: pericapsular calcifications or acetabular rim osteophytes (24%), femoral neck deformity (10%), femoral neck and acetabular rim disorders (18%), neck groove caused by impingement (4%). Radiographic evaluation of those individuals showed a high number of bone abnormalities around the hip joint. This was considered to be an important finding to guide a decision-making process between three different approaches: changing the type of sports practiced, undergoing a more restrictive surgery (such as a double-bundle intra-articular reconstruction or an intra plus extra technique) or the onset of a hip-stretching program in addition to the conventional ACL rehabilitation protocol. In this last option, ACL-operated patients without radiographic hip abnormalities may have better outcomes for their decreased hip range of motion when submitted to a stretching program targeting the prevention of rotational overload on the reconstructed intra-articular grafts. The decision-making process concerning soccer players with ACL ruptures should take into consideration the amount of motion-limiting abnormalities around the hip joint.