Shallow under load? Prevalence of acetabular morphologies and their association with sport exposure during skeletal maturation in professional female football players: a retrospective study using data from the PROFE cohort

We aimed to report the prevalence of acetabular morphologies in professional female footballers and explore the association between these morphologies and sport exposure during the period of skeletal maturation. 100 professional female footballers (200 hips) were included. Athletes with a history of systemic disease were excluded. Questionnaires obtained information on previous sport frequencies and age of menarche. Participants reported the minimum hours of sport played weekly during three age categories/stages of growth: cartilaginous hypertrophy (8–10 years), skeletal growth (11–12 years), and closure of growth plates (13–16 years). Participants underwent a pelvic radiograph. The Wiberg-center edge angle classified hips with normal coverage, borderline dysplasia, dysplasia or pincer morphology. Logistic regression models explored the association between prevalence of acetabular morphologies and minimum of sport hours played weekly in different age groups. Interactions with age of menarche were explored. From 200 hips, 32% were classified as having borderline dysplasia, 9% had dysplasia, 1% had pincer morphology, and 58% had normal coverage. Athletes with a later age of menarche had higher odds of dysplasia with increasing sport exposure between 8–10 (OR [95%CI] = 1.23 [1.05–1.44]). p = 0.011) and 11–12 years (OR [95%CI] = 1.21 [1.06–1.38], p = 0.006) compared to those with an earlier age of menarche. Skeletal maturation might be an important period for the development of acetabular morphology in female footballers. Exposure to high‑load sport activity during skeletal maturation and age of menarche may contribute to the development of hip dysplasia in these athletes.