ISAKOS: 2019 Congress in Cancun, Mexico
ISAKOS

2019 ISAKOS Biennial Congress ePoster #650

 

Arthroscopic Treatment of Hip Labral Tears and Instability in Professional Dancers

Sivashankar Chandrasekaran, MBBS, FRACS, Melbourne, VIC AUSTRALIA
Nader Darwish, BS, Chicago, IL UNITED STATES
John P. Walsh, MA, Des Moines, IA UNITED STATES
Parth Lodhia, MD, Surrey, BC CANADA
Carlos E. Suarez-Ahedo, MD, Mexico City MEXICO
Benjamin G. Domb, MD, Chicago, IL UNITED STATES

American Hip Institute, Chicago, IL, UNITED STATES

FDA Status Not Applicable

Summary

For dancers, an arthroscopic approach that entails labral preservation, minimal acetabuloplasty, and capsular plication is associated with improvements in pain and PROs.

Abstract

Background

The purpose of this study was to report on patterns of clinical presentation and intra-articular derangements, radiological associations and minimum two-year outcomes following arthroscopy labral treatment and capsular plication in patients who are professional dancers. It is hypothesized that hip arthroscopy with attention to restoring soft tissue constraints may lead to improved outcomes in this subpopulation.

Methods

This study was a prospective case series on professional dancers who underwent hip arthroscopy for treatment of painful intra-articular disorders that had failed non-operative management during the study period from April 2008 to April 2013. The inclusion criteria were professional dancers without a history of previous hip conditions or hip surgery. The following were recorded in the study population: demographic, examination, radiological and intra-operative findings, intra-operative procedures performed, patient reported outcomes and patient satisfaction.

Results

Fourteen patients met the inclusion criteria, of which 14 patients had two-year follow-up. Physical examination in this cohort revealed above average range of hip motion, positive impingement signs and a mean Beighton’s score of 5.6 (95%CI 4-8.3). Mean LCEA, ACEA and acetabular inclination were 21.30 (95%CI 17-25.9) 22.70 (95CI 15.2-30.2) and 6.180 (95%CI -0.1-13.1) respectively. The mean alpha angle was 58.30 (95%CI 41.1-75.6) mean femoral anteversion was 21.30(95%CI 9.2-36.2). There were significant improvements in the mean of all patient-reported outcomes. The largest improvement was 35.5 points in the Hip Outcome Score Activities of Daily Living and mean patient satisfaction was 8.14.

Conclusion

The pattern of labral injury in professional dancers is most likely due to instability and soft tissue laxity. Morphological features in this cohort include borderline dysplasia and increased femoral anteversion. An arthroscopic approach that entails, labral preservation, minimal acetabuloplasty, and capsular plication along with bony correction of impingement are associated with improvements in patient outcomes and pain at minimum two-year follow-up