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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Long Term Outcomes After Arthroscopic Treatment Of Femoroacetabular Impingement For Patients With Borderline Dysplasia Abstract Presentation 4 minutes Ryan S. Selley, MD, UNITED STATES Molly A Day, MD, UNITED STATES Reena Olsen, BS, 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
Amniotic Suspension Allograft Injection For Hip Osteoarthritis: Prospective Pilot Study With 1 Year Follow Up Abstract Presentation 5 minutes Marc R. Safran, MD, Prof., UNITED STATES Molly Claire Meadows, MD, UNITED STATES Katia Elisman, BS, UNITED STATES Shane Nho, MD, MS, UNITED STATES
Risk Factors For Early Conversion To Hip Arthroplasty Following Hip Arthroscopy: A Matched Cohort Analysis Abstract Presentation 4 minutes Joseph J. Ruzbarsky, MD, UNITED STATES Max Seiter, MD, UNITED STATES Rui Soares, BS, UNITED STATES Lauren Pierpoint, PhD, UNITED STATES Karen K. Briggs, MPH, MBS, UNITED STATES Marc J. Philippon, MD, UNITED STATES
Utilizing Laser Doppler Flowmetry To Measure Labral Blood Flow During Arthroscopic Acetabular Labral Repair Abstract Presentation 5 minutes Paul F Abraham, BS, UNITED STATES Mark R. Nazal, MPH, UNITED STATES Nathan Varady, MD, MBA, UNITED STATES Michael Peter Kucharik, BS, UNITED STATES Christopher T Eberlin, BS, UNITED STATES Stephen M Gillinov, AB, UNITED STATES Wendy Madeline Meek, BBA, UNITED STATES Scott D Martin, MD, UNITED STATES
Health Literacy in Hip Arthroscopy: A Quantitative Assessment of the Understandability and Readability of Online Patient Education ePoster Presentation Alan Shamrock, MD, UNITED STATES Burke Gao, MD, UNITED STATES Olivia O'Reilly, MD, UNITED STATES Mary Kate Skalitzky, BA, UNITED STATES Trevor Gulbrandsen, MD, UNITED STATES Michael C. Willey, MD, UNITED STATES Robert W. Westermann, MD, UNITED STATES
Does MRI Scan Enable Optimally Informed Pre-Operative Planning In Hip Arthroscopy? Abstract Presentation 5 minutes Vitali Goriainov, FRCS (Orth), BM, PhD, MSc, UNITED KINGDOM Fadi Hindi, BM, MRCS, UNITED KINGDOM Andrew Langdown, BSc MB ChB FRCS(Tr&Orth), UNITED KINGDOM
Clinical Predictors of Outcome Following Proximal Hamstring Tendon Repair ePoster Presentation Heath Patrick Gould, MD, UNITED STATES William Rate, MS, MD, UNITED STATES Matthew Civilette, MD, UNITED STATES John Hamilton, MD, UNITED STATES James Dreese, MD, UNITED STATES
Outcomes of Proximal Hamstring Tendon Repair in Patients Older than 50 Years of Age Abstract Presentation 5 minutes Alexander Rainer Manuel Bitzer, MD, UNITED STATES Daniel Hurwit, UNITED STATES Julian Joseph Sonnenfeld, MD, UNITED STATES Durham Weeks, MD, UNITED STATES
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
The Surgeon Mentor Program: Outcomes of Total Hip Arthroplasty via the Direct Anterior Approach ePoster Presentation Christopher J. Wilson, A/Prof, MBChB, MRCS, FRACS, PhD, AUSTRALIA Melinda Jiang, MD, AUSTRALIA Mark Inglis, FRACS BMBS B Med Sci FOrthoA, AUSTRALIA David Morris, MD, AUSTRALIA Nathan Eardley-Harris , MBBS, MClinSc, AUSTRALIA
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
Mortality After Hip Or Knee Arthroplasty For Osteoarthritis In Chile ePoster Presentation Maximiliano Andres Barahona, MD, MSc, CHILE Cristian Barrientos, MD, CHILE Alvaro Martinez, MD, CHILE Julian Brañes, MD, CHILE Juan Pablo Prieto, MD, CHILE Jaime Hinzpeter, MD, CHILE
Midterm Outcomes Following Hip Labral Augmentation Abstract Presentation 4 minutes Joseph J. Ruzbarsky, MD, UNITED STATES Rui Soares, BS, UNITED STATES Justin W. Arner, MD, UNITED STATES Lauren Pierpoint, PhD, UNITED STATES Maitland Martin, BS, UNITED STATES Spencer M Comfort, BS, UNITED STATES Marc J. Philippon, MD, UNITED STATES
Radiographic Indices Are Not Predictive Of Clinical Outcome Among 1,735 Patients Indicated For Hip Arthroscopy: A Machine Learning Analysis Abstract Presentation 5 minutes Prem N Ramkumar, MD, MBA, UNITED STATES Jaret M Karnuta, MS, UNITED STATES Heather S Haeberle, MD, UNITED STATES Spencer Sullivan, BS, UNITED STATES Danyal H. Nawabi, MD, FRCS(Orth), UNITED STATES Anil S. Ranawat, MD, UNITED STATES Bryan T. Kelly, MD, UNITED STATES Benedict U. Nwachukwu, MD, MBA, UNITED STATES
Are Femoral And Tibial Derotation Osteotomies Effective In Improving Hip And Knee Pain And Function? 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

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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

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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