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

OBJECTIVE: 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. DESIGN: Systematic review and meta-analysis. DATA SOURCES: MEDLINE, Web of Science, SPORTDiscus, PEDro, Embase and Scopus. ELIGIBILITY CRITERIA: 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. RESULTS: 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