Rintje Agricola

• MSc, MD, PhD
• Orthopaedic Surgeon at Erasmus MC

Background Restricted hip range of motion (ROM) is a common finding in patients with femoroacetabular impingement (FAI) syndrome. However, the association between hip ROM and symptom severity in these individuals is unclear. Objective Explore associations between symptom severity and hip flexion and rotation ROM in patients with FAI syndrome and d...

Background The relationship between hip/groin pain and hip range of motion (ROM) is unclear. Purpose To explore the relationship between hip/groin pain and hip joint ROM and examine the influence of sex and cam morphology on this relationship. Study Design Cross-sectional study; Level of evidence, 3. Methods Included were 184 amateur soccer and...

Abstract Objective To determine the reliability and agreement of manual and automated morphological measurements, and agreement in morphological diagnoses. Methods Thirty pelvic radiographs were randomly selected from the World COACH consortium. Manual and automated measurements of acetabular depth-width ratio (ADR), modified acetabular index (mAI...

Background Cam morphology develops during skeletal growth, but its influence on cartilage and the labrum in high-impact athletes later in life is unknown. Purpose To (1) explore the association between the presence and duration of cam morphology during adolescence and the cartilage and labral status 7 to 12 years later and (2) report the prevalenc...

Objective The objective is to determine the association and absolute risk of femoroacetabular impingement syndrome (FAIS) for the development of radiographic hip osteoarthritis (RHOA). Methods This is a nationwide, multicentre prospective cohort study (Cohort Hip and Cohort Knee) with 1002 individuals aged between 45 and 65 years. Hips without def...

Objective: To explore and gain more insight into the usual preoperative and postoperative physical therapy (PT) treatment of patients with a total knee arthroplasty (TKA) among Dutch physical therapists experienced with TKA rehabilitation. Secondly, to evaluate physical therapists' adherence to guideline recommendations for postoperative rehabilita...

Purpose Hip osteoarthritis (OA) is a major cause of pain and disability worldwide. Lack of effective therapies may reflect poor knowledge on its aetiology and risk factors, and result in the management of end-stage hip OA with costly joint replacement. The Worldwide Collaboration on OsteoArthritis prediCtion for the Hip (World COACH) consortium was...

Objective The objective of this study was to assess the relationship between pincer morphology and radiographic hip osteoarthritis (RHOA) over 2, 5, 8, and 10 years’ follow‐up and to study the interaction between pincer morphology and pain. Methods Individuals from the prospective Cohort Hip and Cohort Knee study were drawn. Anteroposterior pelvic...

Objectives To investigate hip dysplasia as a risk factor for clinically relevant and incident radiographic hip OA. Methods From a prospective cohort (CHECK) of 1002 middle-aged, new consulters for hip and/or knee pain, 468 hips (251 individuals) were selected based on hip pain, available lateral center edge angle (LCEA) and absence of definite rad...

OBJECTIVE: In symptomatic football players with hip dysplasia, we aimed to explore the relationships between self-reported sport and recreation ability and (1) hip muscle strength, (2) functional performance, and investigate if these relationships were modified by sex or cartilage defects. METHODS: In this cross-sectional study, football players (n...

Background Despite the huge burden of hip osteoarthritis (OA) and the lack of effective treatment, research into the primary prevention of hip OA is in its infancy. Purpose We sought to evaluate risk factors for incident clinical and incident radiographic hip OA among middle-aged and older adults, to evaluate the importance of risk factors from a...

Acetabular dysplasia is one of the most common causes of early hip osteoarthritis and hip replacement surgery. Recent literature suggests that acetabular dysplasia does not always originate at infancy, but can also develop later during childhood. This systematic review aims to appraise the literature on prevalence numbers of acetabular dysplasia in...

Far more publications are available for osteoarthritis of the knee than of the hip. Recognizing this research gap, the Arthritis Foundation, in partnership with the Hospital for Special Surgery, convened an in-person meeting of thought leaders to review the state of the science of and clinical approaches to hip osteoarthritis. This article summariz...

Objective: To compare hip muscle strength and functional performance in football players with and without hip dysplasia and investigate if the relationships were modified by sex. Design: Cross-sectional study. Methods: This study compared football players with hip dysplasia (HD group) and without hip dysplasia (control group). Hip muscle stren...

Objective: To determine the association between cam morphology and the development of radiographic hip osteoarthritis (RHOA) at four time points within 10-year follow-up. Design: The nationwide prospective Cohort Hip and Cohort Knee (CHECK) study includes 1002 participants aged 45-65 years with 2-, 5-, 8-, and 10-year follow-ups. The association...

Introduction: The pubic symphysis is susceptible to growth related injuries long after the adolescent growth spurt. Our study describes the radiographic maturation of the pubic symphysis on pelvic radiographs in adolescent football players and introduces the Maturing Adolescent Pubic Symphysis classification (MAPS classification). Methods: Anter...

Background: Femoroacetabular impingement (FAI) syndrome is considered a motion-related condition. Little is known about the influence of symptom severity and cam morphology on hip biomechanics for individuals with FAI syndrome. Research question: Are hip biomechanics during running associated with symptom severity or cam morphology size in male...

Purpose The objectives of this study were to develop recommendations for clinical and radiographic criteria to help define the “acceptable” surgical correction of femoroacetabular impingement syndrome (FAIS) and identify/define complications postoperatively. Methods A three-phase modified Delphi study was conducted involving a case-based survey; a...

Background The purpose of this pilot study was to validate the feasibility of a definitive study aimed at determining if high-intensity physical activity during adolescence impacts the development of femoroacetabular impingement (FAI). Methods This prospective cohort pilot study had a sample size target of 50 volunteers between 12 and 14 years old...

Background It is unknown if football players with femoroacetabular impingement (FAI) syndrome report worse burden than those with other causes of hip/groin pain, and to what extent this is mediated by cartilage defects and labral tears. Hypothesis Football players with FAI syndrome would report worse burden than other symptomatic players, with the...

Background: Cam morphology contributes to the development of hip osteoarthritis (OA) but is less studied in the general population. This study describes its associations with clinical and imaging features of hip OA. Methods: Anteroposterior hip radiographs of 1019 participants from the Tasmanian Older Adult Cohort (TASOAC) were scored at baselin...

The aim of this study was to determine the additional value of the false-profile (FP) view radiograph in the diagnosis of developmental dysplasia of the hip (DDH), as compared with an anteroposterior (AP) pelvic radiograph only, and evaluate the correlation between the Wiberg-lateral center edge angle (W-LCEA) and Wiberg-anterior center edge angle...

Cam morphology size and location might affect the severity of reported burden in people with femoroacetabular impingement (FAI) syndrome. We investigated the relationship between cam morphology size (i.e., alpha angle) and self-reported hip/groin burden (i.e., scores for the International Hip Outcome Tool-33 (iHOT-33) and Copenhagen Hip and Groin O...

Introduction Pubic-related groin pain can affect young athletes and pubic apophysitis is a potential cause of pain. We aimed to describe the maturation of the pubic symphysis in adolescent football players on x-ray. Materials and Methods 105 anteroposterior radiographs of healthy adolescent male football players between 12 and 24 years old were us...

Hip-related pain in young adults is common and can have several underlying causes. One of the main causes in athletes is femoroacetabular impingement (FAI) syndrome and/or labral tears. In the past decade, a better understanding of these hip conditions has led to improved diagnosis and treatment. In the current chapter, a general introduction on FA...

Objective Football players are at risk of developing hip osteoarthritis (OA). Cam morphology (present in almost two of every three football players) may explain this heightened risk, but there is limited research on its role in hip OA development in younger athletes. Knowledge of this relationship will advance our understanding of the aetiology of...

Objective To appraise the highest evidence on hip morphology as a risk factor for developing hip osteoarthritis (OA). Design We searched for studies evaluating the association between radiological hip morphology parameters and the prevalence, incidence or progression of hip OA (based on different radiographic and clinical criteria) in the MEDLINE,...

Objectives Groin injuries are common in professional male football and result in significant complaints, time-loss and cost. We aimed to study: 1. Normal values of hip muscle strength and self-reported hip and groin function (Hip And Groin Outcome Score (HAGOS)). 2. Changes in these values throughout the season. 3. If previous (groin) injuries, leg...

Due to typographic mistakes made by the editorial office, several corrections have been made. The original article has been corrected.

Objectives: To compare the size and prevalence of bony hip morphology in football players' hips with and without hip and/or groin pain. Design: Case-control. Methods: 184 (290 hips; 20% women) football players (soccer and Australian football) with self-reported hip and/or groin pain (>6 months duration) and a positive FADIR test and 55 (110 hi...

Objective To summarize available evidence on the association between hip shape as quantified by statistical shape modeling (SSM) and the incidence or progression of hip osteoarthritis. Design We conducted a systematic search of five electronic databases, based on a registered protocol (available: PROSPERO CRD42020145411). Articles presenting origi...

Objective To compare early hip osteoarthritis (OA) features on magnetic resonance imaging (MRI) in high-impact athletes with and without hip and/or groin pain, and to evaluate associations between early hip OA features, the International Hip Outcome Tool (iHOT33) and Copenhagen Hip and Groin Outcome Score (HAGOS). Design A cross-sectional analysis...

Purpose: The aim of this study was to (1) investigate whether radiographic and clinical parameters, which influence how stresses during sporting activities act on the proximal femur, are associated with cam morphology or (2) precede cam morphology development. Methods: Young male football players participated at baseline (n = 89, 12-19 years of...

Objectives To determine normal values for hip strength and range of motion (ROM) of elite, sub-elite and amateur male field hockey players and to examine the effect of age, leg dominance, playing position, playing level and non-time-loss groin pain on hip strength and ROM. Design Cross-sectional study. Setting Physical testing took place at field...

Background The alpha angle is the most often used measure to classify cam morphology. There is currently no agreement on which alpha angle threshold value to use. Purpose To systematically investigate the different alpha angle threshold values used for defining cam morphology in studies aiming to identify this threshold and to determine whether da...

Background The primary aim of this study was to determine the prevalence of cam morphology in a cohort of people aged 40–55 years. Secondary aims were to: (1) determine differences in participant characteristics, physical impairments, radiographic and ultrasound appearances of people with and without cam morphology; and (2) explore associations bet...

Background Conflicting and limited high quality prospective data is available on the associations between cam morphology and hip and groin symptoms and range of motion (ROM). Objectives This cross‐sectional cohort study investigated associations between cam morphology presence, size and duration and symptoms and ROM. Methods Academy male football...

Hip-related pain is a well-recognised complaint among active young and middle-aged active adults. People experiencing hip-related disorders commonly report pain and reduced functional capacity, including difficulties in executing activities of daily living. Patient-reported outcome measures (PROMs) are essential to accurately examine and compare th...

There is no agreement on how to classify, define or diagnose hip-related pain—a common cause of hip and groin pain in young and middle-aged active adults. This complicates the work of clinicians and researchers. The International Hip-related Pain Research Network consensus group met in November 2018 in Zurich aiming to make recommendations on how t...

Hip-related pain can significantly impact quality of life, function, work capacity, physical activity and family life. Standardised measurement methods of physical capacity of relevance to young and middle-aged active adults with hip-related pain are currently not established. The aim of this consensus paper was to provide recommendations for clini...

The 1st International Hip-related Pain Research Network meeting discussed four prioritised themes concerning hip-related pain in young to middle-aged adults: (1) diagnosis and classification of hip-related pain; (2) patient-reported outcome measures for hip-related pain; (3) measurement of physical capacity for hip-related pain; (4) physiotherapist...

Objective: To design an automated workflow for hip radiographs focused on joint shape and tests its prognostic value for future hip osteoarthritis. Design: We used baseline and eight-year follow-up data from 1002 participants of the CHECK-study. The primary outcome was definite radiographic hip osteoarthritis (rHOA) (Kellgren-Lawrence grade ≥2 o...

The original article can be found online.

Background In athletes, hip and groin pain is considered to be associated with hip intra-articular pathologies and hip osteoarthritis (OA). A greater understanding of the relationship between hip and groin pain and imaging findings is required. Objective Our objective was to undertake a systematic review and meta-analysis to determine the prevalen...

Our aim was to assess the ability of radiography-based bone texture parameters in proximal femur and acetabulum to predict incident radiographic hip osteoarthritis (rHOA) over a 10 years period. Pelvic radiographs from CHECK (Cohort Hip and Cohort Knee) at baseline (987 hips) were analyzed for bone texture using fractal signature analysis in proxim...

Objective: To assess the ability of radiography-based bone texture variables in proximal femur and acetabulum to predict incident radiographic hip osteoarthritis (rHOA) over a 10 years period. Design: Pelvic radiographs from CHECK at baseline (987 hips) were analyzed for bone texture using fractal signature analysis (FSA) in proximal femur and a...

Please check the hierarchy of the sections and correct if necessary.

Objectives Cam morphology is not completely understood. The aim of this study was threefold: (1) to investigate if cam morphology development is associated with growth plate status; (2) to examine whether cam morphology continues to develop after growth plate closure; and (3) to qualitatively describe cam morphology development over 5-year follow-u...

Background Hip-related groin pain is common in sub-elite football players and may be associated with altered hip biomechanics. Objectives To compare the hip biomechanics, bony hip morphology associated with femoroacetabular impingement (FAI) syndrome, and hip strength and range of motion (ROM) between the symptomatic and asymptomatic limbs of sub-...

Background: The prevalence of radiographic hip osteoarthritis (OA), and its relationship with outcomes after hip arthroscopy is unclear. Objectives: The aims of this study were to: (i) describe the prevalence of OA and cam deformity 12-24 months post hip arthroscopy; (ii) to determine the association between radiographic OA and cam deformity, su...

Background: Musculoskeletal hip/groin screening tests are commonly performed to detect at-risk individuals. Bony hip morphology is considered a potential intrinsic risk factor but has not been examined prospectively. Purpose: To evaluate the association between intrinsic risk factors identified from musculoskeletal and radiographic screening tes...

Study Design Cross-sectional cohort study. Objectives To investigate the relationship between musculoskeletal screening findings and bony hip morphology in asymptomatic male soccer players. Background Athletes with femoroacetabular impingement (FAI) syndrome have cam and/or pincer morphology, pain on orthopaedic testing, and often reduced hip ran...

Synopsis Our understanding of femoroacetabular impingement syndrome is slowly improving. The number of studies on all aspects (etiology, prevalence, pathophysiology, natural history, treatment, and preventive measures) of femoroacetabular impingement syndrome has grown exponentially over the past few years. This commentary provides the latest updat...

Background: Many patients with osteoarthritis (OA) of the knee and/or hip undergo total joint replacement (TJR) because of severely progressed symptoms. Aim: To determine patient and disease characteristics associated with undergoing TJR in participants with recent-onset knee and/or hip OA. Design and setting: Participants with hip or knee pai...

Objective: To examine the prevalence of different causes of groin pain in athletes using the recent Doha consensus classification of terminology and definitions of groin pain in athletes. Design: Descriptive epidemiological study. Setting: Multidisciplinary sports groin pain clinic at Aspetar Orthopedic and Sports Medicine Hospital, Doha, Qata...

PurposeThe influence of type and intensity of sports during growth on knee alignment was investigated. The second aim was to ascertain whether the distal femur or proximal tibia contribute most to knee alignment. Also, the influence of field position and leg dominancy on knee alignment in soccer players was audited. Methods Standardized full-leg st...

The 2016 Warwick Agreement on femoroacetabular impingement (FAI) syndrome was convened to build an international, multidisciplinary consensus on the diagnosis and management of patients with FAI syndrome. 22 panel members and 1 patient from 9 countries and 5 different specialties participated in a 1-day consensus meeting on 29 June 2016. Prior to t...

Objective: Cam deformity and acetabular dysplasia have been recognized as relevant risk factors for hip osteoarthritis (OA) in a few prospective studies with limited sample sizes. To date, however, no evidence is available from prospective studies regarding whether the magnitude of these associations differs according to sex, body mass index (BMI)...

Background: Participation in high-impact athletic activities has recently been associated with a higher prevalence of cam deformity. Bony hip morphology has also emerged as an important factor in the development of hip osteoarthritis. However, it is unknown whether bony morphology differs between ethnicities in athletes participating in high-impac...

Purpose The influence of type and intensity of sports during growth on knee alignment was investigated. The second aim was to ascertain whether the distal femur or proximal tibia contribute most to knee alignment. Also, the influence of field position and leg dominancy on knee alignment in soccer players was audited.