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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
JAPAN

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, JAPAN Yoichi Murata, MD, JAPAN Hajime Utsunomiya, MD, PhD, JAPAN Tsukamoto Manabu, MD, PhD, JAPAN Akihisa Hatakeyama, MD, JAPAN Shiho Kanezaki, MD, PhD, JAPAN Akinori Sakai, MD, PhD, JAPAN

Wakamatsu hospital for University of Occupational and Environmental Health, Kitakyushu, Fukuoka, JAPAN

2021 Congress   Abstract Presentation   4 minutes   Not yet rated

 

Anatomic Location

Hip / Groin / Thigh

Anatomic Structure

Labrum Bones

Diagnosis / Condition

Instability

Treatment / Technique

Endoscopy Arthroscopy Osteotomy Sutures / Knots / Anchors

Patient Populations

Female Athletes Sport Specific Population

Diagnosis Method

Physical Examination X-ray MRI

Sports Medicine

Sport Specific Injuries Outcome Studies

Bones

Growth Abnomalities

Labrum

Labrum Tears Labrum Treatment

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Summary: Endoscopic shelf acetabuloplasty enabled artistic dancers to return to play with a high success rate.

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

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