Epidemiology of hip and groin injuries in sport: a systematic review with meta-analysis and meta-regression of 5914 injuries from over 9 million exposure hours.

Abstract

To systematically review hip and groin injury (HGI) incidence, burden, prevalence and the proportion of HGI relative to all injuries in competitive sports. A secondary aim was to determine the impact of potential effect moderators on the incidence of HGI in athletes. Systematic review and meta-analysis. MEDLINE, Web of Science, SPORTDiscus, PEDro, Embase and Scopus. Prospective studies reporting a minimum of one epidemiological measure: HGI injury incidence, burden, prevalence or proportion of all injuries. Reporting quality was assessed using the checklist of issues that should be included in reports of football injury studies. 71 studies (85% football studies) comprising 5914 injuries across 9 441 381 exposure hours were included. HGI incidence was 0.71/1000 hours, accounting for 11% of all injuries, with 6% affecting the hip adductors (0.41/1000 hours). Injury burden was 11.5 days per 1000 hours, while seasonal prevalence was 19%. HGI incidence rate increased with higher average cohort age (p=0.046). The incidence rate was 1.8 times higher in male compared with female athletes (95% CI 1.25 to 2.7, p=0.004), and 6.5 times higher during matches compared with training sessions (95% CI 3.9 to 10.9, p<0.001). Injury incidence was not significantly moderated by average cohort height (p=0.87), body mass (p=0.52), body mass index (p=0.58), year of data collection (p=0.13) or playing level (p=0.89). The incidence of HGI is 0.7 per 1000 hours of exposure, comprising 11% of all sporting injuries. Incidence rates increase with older age, and males are at higher risk of injury compared with females. The high proportion of HGI warrants efforts to reduce the occurrence of groin injuries in sport. CRD42024573833.