ePoster #1002 - ISHA Annual Scientific Meeting 2016

Arthroscopic Treatment Of Labral Tears And Instability In Professional Dancers: Patterns Of Clinical Presentation And Intra-Articular Derangements, Radiological Associations, And Minimum Two-Year Outcomes

Sivashankar Chandrasekaran, MBBS, FRACS, Westmont, IL UNITED STATES
Nader Darwish, BS, Chicago, IL UNITED STATES
John P. Walsh, MA, Westmont, IL UNITED STATES
Parth Lodhia CANADA
Carlos Suarez Ahedo, MD, Mexico City, DF MEXICO
Benjamin G. Domb, MD, Chicago, IL UNITED STATES

American Hip Institute, Westmont, IL, UNITED STATES

FDA Status Not Applicable

Summary: Common morphological features found in our cohort of dancers include borderline dysplasia and increased femoral anteversion; this study showed that an arthroscopic approach that entails labral preservation, minimal acetabuloplasty, and capsular plication is associated with improvements in pain and PROs.

Abstract:
Background: Approximately 25% of injuries sustained by dancers involve the hip region. The extreme hip motion required for dancing coupled with ligamentous laxity may lead to labral damage despite osseous anatomy atypical for femoroacetabular impingement. We hypothesize that hip arthroscopy intending to restore soft tissue constraints may lead to improved outcomes in this subpopulation. The purpose of this study was to report patterns of clinical presentation and intra-articular derangements, radiological associations, and minimum two-year outcomes following arthroscopic labral treatment and capsular plication professional dancers. Methods: This study was a prospective case-series on professional dancers who underwent hip arthroscopy to treat painful intra-articular disorders that had failed non-operative management during the study period (April 2008-2013). The inclusion criteria were professional dancers with no history of previous hip conditions/hip surgery. The following were recorded in the study population: demographic, examination, radiological and intra-operative findings, intra-operative procedures, patient reported outcomes(PROs), and patient satisfaction. Results: 14 patients met the inclusion criteria, of which 14(100%) patients had two-year follow-up. Physical examination revealed above average range of hip motion, positive impingement signs, and a 5.6 mean Beighton’s score. Mean LCEA, ACEA, and acetabular inclination were 21.30, 22.70, and 6.180 respectively. The mean alpha angle was 58.30, mean femoral anteversion was 21.30. 57/1% of patients had a Seldes type 1 tear, with a mean tear size of 1.86. There were significant improvements in PROs means. The largest improvement was 35.5 points, the Hip Outcome Score-Activities of Daily Living; 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. Common morphological features in this cohort include borderline dysplasia and increased femoral anteversion. An arthroscopic approach that entails labral preservation, minimal acetabuloplasty, and capsular plication is associated with improvements in pain and PROs.