Self-Reported Hip Crepitus Is Prevalent in Football Players With Hip/Groin Pain, but Is It Associated With Early Hip Osteoarthritis Structural Features? A Longitudinal Study

<b>OBJECTIVES:</b> (1) To compare the prevalence of self-reported hip crepitus between football (soccer and Australian football) players with and without hip/groin pain. In players with hip/groin pain, to (2) explore the association of hip crepitus with early hip osteoarthritis structural features, and (3) explore the association between hip crepitus and the change in these features over 2 years. <b>METHODS:</b> Data from 178 subelite football players with hip/groin pain and 60 pain-free controls were analyzed. The presence and severity of hip crepitus were assessed using a single item of the Copenhagen Hip and Groin Outcome Score and the International Hip Outcome Tool-33, respectively. Participants had radiographs and 3-Tesla magnetic resonance imaging. Bony hip morphology was evaluated using the alpha angle and lateral center-edge angle. The scoring of hip osteoarthritis with magnetic resonance imaging classification was used to evaluate cartilage defects and labral tear presence, location, and severity. Regression models explored the prevalence and associations of self-reported hip crepitus with early hip osteoarthritis features. <b>RESULTS:</b> Football players with hip/groin pain had a higher prevalence (prevalence ratio = 5.0; 95% CI: 2.5, 10.2) of hip crepitus compared to controls. Hip crepitus was only associated with the number of cartilage subregions affected in the hip/groin pain group (odds ratio = 2.08; 95% CI: 1.05, 4.11; <i>P</i> = .03) at baseline, but not with other features. <b>CONCLUSION:</b> Football players with hip/groin pain had a higher prevalence and severity of hip crepitus compared to controls. Hip crepitus was associated with the number of cartilage subregions affected in football players. <i>J Orthop Sports Phys Ther 2026;56(2):119-127. Epub 26 December 2025. doi:10.2519/jospt.2025.13474</i>.