2021 ISAKOS Biennial Congress Paper
Endoscopic Shelf Acetabuloplasty Concomitant With Labral Repair, Cam Osteoplasty, And Capsular Plication For Treating Artistic Dancers In The Setting Of Acetabular Dysplasia: A Case Series
Soshi Uchida, MD, PhD, Kitakyushu, Fukuoka JAPAN
Yoichi Murata, MD, Kitakyushu, Fukuoka JAPAN
Hajime Utsunomiya, MD, PhD, Tokyo , Tokyo JAPAN
Tsukamoto Manabu, MD, PhD, Kitakyushu, Fukuoka JAPAN
Akihisa Hatakeyama, MD, Kitakyushu, Fukuoka JAPAN
Shiho Kanezaki, MD, PhD, Kawasaki, Kanagawa JAPAN
Akinori Sakai, MD, PhD, Kitakyushu, Fukuoka JAPAN
Wakamatsu hospital for University of Occupational and Environmental Health, Kitakyushu, Fukuoka, JAPAN
FDA Status Not Applicable
Summary
Endoscopic shelf acetabuloplasty enabled artistic dancers to return to play with a high success rate.
Abstract
Background
Knowledge of clinical outcomes and return to play after endoscopic shelf acetabuloplasty (ESA) for acetabular dysplasia in artistic athletes is lacking.
Hypothesis
Hip arthroscopic surgery including ESA will enable artistic athletes to return to play with a high success rate, significantly improved acetabular coverage, and preserved joint cartilage.
Study Design: Case series; Level of evidence, 4.
Methods
We reviewed 28 hips in 23 female artistic athletes (sport: 14 ballet, 9 rhythmic gymnastics, 4 dance, 1 baton twirling) who underwent arthroscopic labral preservation, capsular plication, and ESA. The mean age was 25.8 ± 10.2 years. Preoperatively, all patients had generalized joint laxity (Beighton score, 7.1 ± 1.8). Preoperative and postoperative radiographs and outcome scores (modified Harris hip score [mHHS]; nonarthritic hip score [NAHS]; International Hip Outcome Tool 12 [iHOT-12]; Vail hip score [VHS]; and Hip Outcome Score–Sports [HOS-Sports]) were evaluated. Statistical analysis was performed using paired t tests and Bonferroni correction.
Results
The mean follow-up was 32.5 ± 12.5 months. The mean LCEA significantly increased from preoperatively (15.7° ± 5.3°) to postoperatively (39.8° ± 8.2°; p < 0.001) and at the final follow-up (33.7° ± 8.6°; p < 0.001). The VCA angle significantly improved from preoperatively (16.2° ± 8.8°) to final follow-up (33.6° ± 8.0°; p < 0.001). All hips maintained a Tönnis grade of 0 or 1 at the final follow-up. Overall, 20 patients (87%) were able to return to their preinjury level. All outcome scores improved from preoperatively to postoperatively: mHHS, from 68.5 ± 18.1 to 88.3 ± 18.5; NAHS, from 50.8 ± 17.7 to 69.0 ± 11.4; iHOT-12, from 36.9 ± 19.3 to 75.2 ± 19.8; VHS, from 53.8 ± 13.7 to 79.4 ± 19.4; and HOS-Sports, from 59.9 ± 17.0 to 79.6 ±21.3 (p < 0.001 for all). Three patients could not return to play owing to postoperative deep gluteal syndrome.
Conclusion
ESA concomitant with labral repair, cam osteoplasty, and capsular plication to treat dysplastic hips in patients with joint laxity enabled artistic athletes to return to play with a high success rate.
Key terms: hip arthroscopy, acetabular dysplasia, endoscopic shelf acetabuloplasty, capsular plication, artistic dancers