Summary: Outcomes of hip arthroscopy among bull riders are often favorable, despite common findings of restricted motion, grade IV chondral damage and Tönnis 2 radiographic changes.

Introduction

Restricted range of motion, grade 4 chondral damage, and Tönnis radiographic changes greater than 1 are considered harbingers of poor outcome and possibly contraindications to hip arthroscopy. However, all of these findings are almost uniformly present among bull riders seeking treatment. The purpose of this study is to report on clinical observations in this population and outcomes of arthroscopic intervention, and how these observations may reflect on care in other cohorts.

Methods

Patients undergoing hip arthroscopy are prospectively assessed with a modified Harris Hip Score. Twenty-one consecutive hips among 16 bull riders (5 bilateral) were identified that had achieved minimum 2 year followup, and represent the substance of this report.

Results

Among the 16 bull riders (21 hips) there were 14 professional and 2 collegiate cowboys. The average age was 26 years (range 20 - 33 years). Duration of symptoms averaged 33 months (range 2 – 130 months), and followup averaged 48 months (range 12 - 120 months). There were 10 right and 11 left hips. 14 of the cowboys were right handed, although only 13 rode right handed. The average weight was 155 pounds (range 125 - 170 pounds); height averaged 69” (range 66” - 72’). Range of motion was as follows: total arc averaged 31° (range 20° - 70°); internal rotation averaged 3° (range 0° - 20°); external rotation averaged 27° (range 20° - 50°).

All had FAI, including 17 combined and 4 cam type. Among the cam types, 1 also had dysplasia and 1 borderline dysplasia. Radiographic Tönnis grades included 2 Tönnis 1; 18 Tönnis 2, 1 Tönnis 3. All had acetabular articular damage including: 14 grade 4; 6 grade 3; 1 grade 1. Nine underwent microfracture. Four had accompanying femoral chondral lesions (3 grade 3, 1 grade 4). There were 20 labral tears of which 14 underwent repair and 6 debridement.

All but one (95%) were improved following surgery. One bilateral case underwent conversion to a resurfacing arthroplasty on one side and revision arthroscopy on the other. The average improvement was 22 points (preop 63; postop 85) with a range of -12 to 45 points. Thirteen cowboys (8%) returned to bull riding at an average of 7 months (range 4 – 17 months) There were no complications.

Discussion And Conclusion

Bull riders tend to be small framed like jockeys built for bulls. Tight hips associated with FAI may be a serendipitous adaptation for bull riders, providing a static (clothes pin) method for the thighs to grip the bull’s girth. Bull riders undergoing hip arthroscopy commonly carry a triple threat of predictors of poorer results: 1) Restricted motion, 2) grade 4 articular changes, and 3) Tönnis 2 radiographic findings. Despite these, with proper selection, they can often benefit substantially from arthroscopic intervention. Understanding the limits in this challenging population may help in deciphering the potential role of arthroscopy for challenging cases in other patient mixes.

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Results After Arthroscopic Treatment Of Iliopsoas Impingement After Total Hip Arthroplasty ePoster Presentation Wolfgang Miehlke, MD, GERMANY Christian Sobau, MD, GERMANY Alexander Zimmerer, MD, GERMANY
Risk Of Conversion To Arthroplasty Following Hip Arthroscopy: Validation Of A Published Risk Score Using An Independent, Prospectively Collected Database Abstract Presentation 4 minutes Mario Hevesi, MD, PhD, UNITED STATES Devin Leland, MD, UNITED STATES Philip Joseph Rosinsky, MD, UNITED STATES Ajay C. Lall, MD, MS, FAAOS, UNITED STATES Benjamin G. Domb, MD, UNITED STATES David E. Hartigan, MD, UNITED STATES Bruce A. Levy, MD, UNITED STATES Aaron J. Krych, MD, UNITED STATES
Stem Cells Injection And Percutaneous Femoral Head Decompression - An Extremely Rare Procedure With Good Results ePoster Presentation Sofia Moura De Carvalho, MD, PORTUGAL Inês Domingues, MD, PORTUGAL Liliana Domingues, MD, PORTUGAL Eduardo Ramalho Silva, MD, PORTUGAL Gonçalo Lavareda, MD, PORTUGAL Filipe Machado, MD, PORTUGAL Rita Ricardo, MD, PORTUGAL
No Association Between Intrauterine Contraceptive Devices and Musculoskeletal Hip Joint Pain Abstract Presentation 5 minutes Nathan Varady, MD, MBA, UNITED STATES Paul F Abraham, BS, UNITED STATES Michael Peter Kucharik, BS, UNITED STATES Christopher T Eberlin, BS, UNITED STATES David Freccero, MD, UNITED STATES Eric L. Smith, MD, UNITED STATES Scott D Martin, MD, UNITED STATES
The Effect Of Osteochondroplasty On Time To Reoperation After Arthroscopic Management Of Femoroacetabular Impingement Abstract Presentation 5 minutes Jeffrey Kay, MD, CANADA Nicole Simunovic, MSc, CANADA Olufemi R. Ayeni, MD, PhD, MSc, FRCSC, CANADA FIRST Investigators, MD, CANADA
Not Every Hip Impingement Requires Hip Arthroscopy. Abstract Presentation 5 minutes Vitali Goriainov, FRCS (Orth), BM, PhD, MSc, UNITED KINGDOM Mohamed Zubair Farook, MBBS, D.Ortho, FRCS (Orth), UNITED KINGDOM Rajiv Kaila, MRCS, MSc, MFSEM(UK), FEBOT, UNITED KINGDOM Tom CB Pollard, MD, FRCS (Tr & Orth), UNITED KINGDOM Antonio J. M. D. Andrade, MB BS, M.Sc., FRCS(Tr&Orth), UNITED KINGDOM
Arthroscopic Tendon Release for Iliopsoas Impingement after Total Hip Arthroplasty ePoster Presentation Michael Andreas Finsterwald, MD, AUSTRALIA Georgina Waters, MD, AUSTRALIA Jay R. Ebert, PhD, AUSTRALIA Christopher W. Jones, FAOrthA FRACS PhD MBBS(Hons) BEng(Hons) BCom, AUSTRALIA Piers Yates, MBBS(Hons) BSc(Hons) MRCS(Eng) FRCS(Tr & Orth) FRA, AUSTRALIA Peter Alberto D'Alessandro, MBBS Hons. (UWA) FRACS FAOrthA, AUSTRALIA
Traumatic Hip Dislocations In The Pediatric Patient: Injury Patterns, Need For Axial Imaging, Outcomes, And Selective Hip Arthroscopy Abstract Presentation 5 minutes Cliff Willimon, MD, UNITED STATES Anthony Egger, MD, UNITED STATES Crystal A. Perkins, MD, UNITED STATES
Capsular Complications And Subsequent Instability On The Rise As Indications For Revision Hip Arthroscopy ePoster Presentation Ryan S. Selley, MD, UNITED STATES Molly A Day, MD, UNITED STATES Reena Olsen, BS, UNITED STATES Cort D. Lawton, MD, UNITED STATES Matthew S. Dooley, MA, UNITED STATES Stephanie S Buza, MD, UNITED STATES Bryan T. Kelly, MD, UNITED STATES Anil S. Ranawat, MD, UNITED STATES Danyal H. Nawabi, MD, FRCS(Orth), UNITED STATES
Hip Arthroscopy in Patients with Borderline Dysplasia. ePoster Presentation Leonel Perez Alamino, MD, ARGENTINA Daniel Fernando Veloz Serrano, Md, ARGENTINA Agustin Felipe Catan, MD, ARGENTINA Tomas Rafael Vilaseca, MD, ARGENTINA
Can BMAC Application Safely Diminish Perioperative Pain In Patients Undergoing Hip Arthroscopy? Abstract Presentation 5 minutes Michael Peter Kucharik, BS, UNITED STATES Paul F Abraham, BS, UNITED STATES Mark R. Nazal, MPH, UNITED STATES Nathan Varady, MD, MBA, UNITED STATES Wendy Madeline Meek, BBA, UNITED STATES Stephen M Gillinov, AB, UNITED STATES Christopher T Eberlin, BS, UNITED STATES Scott D Martin, MD, UNITED STATES
EVALUATION OF HIP ARTHROSCOPY IN ELITE ATHLETES WITHOUT HIP DYSPLASIA . OUR EXPERIENCE. A 15-YEAR STUDY ePoster Presentation George D. Tsikouris, MD, GREECE Nikolaos D. Gravvanis, MD, GREECE Georgia S. Dedousi, MD, GREECE Ioannis K. Antonopoulos, GREECE Fanis P. Papadakis, BSc, MSc(cand.), GREECE Demetrios P. Tsikouris, PT, GREECE Eleftherios Tsikouris, BSc in Physiotherapy, GREECE Theodoros G. Troupis, Prof, GREECE
Treatment of Bilateral Hip Femoroacetabular Impingement: Simultaneous or Staged? Abstract Presentation 5 minutes Gen Lin Foo, MD, SINGAPORE Catherine J. Bacon, PhD, MSc, BSc, BPhed(Hons), NEW ZEALAND Matthew J. Brick, MBChB, FRACS, NEW ZEALAND
A Prospective Comparison Of Groin-Related Complications Following Hip Arthroscopy With Versus Without A Perineal Post ePoster Presentation Iciar M Davila Castrodad, MD, UNITED STATES Matthew J. Kraeutler, MD, UNITED STATES Omer Mei-Dan, MD, UNITED STATES Anthony Scillia, UNITED STATES

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Hip Disorders in Bull Riders: Clinical Observations and Outcomes of Arthroscopy

Hip Disorders in Bull Riders: Clinical Observations and Outcomes of Arthroscopy

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Hip Disorders in Bull Riders: Clinical Observations and Outcomes of Arthroscopy

Hip Disorders in Bull Riders: Clinical Observations and Outcomes of Arthroscopy

Introduction

Methods

Results

Discussion And Conclusion

More ISAKOS 2021: Global Content