Uchida S, Murata Y, Tsukamoto M, Utsunomiya H, Yamanaka Y, Hatakeyama A, Kanezaki S, Sakai A. Endoscopic Shelf Acetabuloplasty Concomitant With Labral Repair, Cam Osteoplasty, and Capsular Plication to Treat Acetabular Dysplasia in Artistic Athletes: A Case Series.
Orthop J Sports Med 2021;
9:23259671211049222. [PMID:
34746325 PMCID:
PMC8564133 DOI:
10.1177/23259671211049222]
[Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 07/19/2021] [Indexed: 11/30/2022] Open
Abstract
Background:
Knowledge of clinical outcomes and return to artistic activities 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 their activities 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 (14 ballet, 9 rhythmic
gymnastics, 4 dance, and 1 baton twirling) who underwent arthroscopic labral
preservation, capsular plication, and ESA. Their mean age was 25.8 ± 10.2
years. Preoperatively, all patients had generalized joint laxity (Beighton
score, 7.1 ± 1.8). We evaluated preoperative and postoperative radiographs
and outcome scores including the 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).
Statistical analysis was performed using paired t tests and
Bonferroni correction.
Results:
The mean follow-up was 32.5 ± 12.5 months. The mean lateral center-edge angle
significantly increased from preoperatively (15.7° ± 5.3°) to
postoperatively (39.8° ± 8.2°; P < .001) and at the
final follow-up (33.7° ± 8.6°; P < .001). The
vertical-center-anterior angle significantly improved from preoperatively
(16.2° ± 8.8°) to final follow-up (33.6° ± 8.0°; P <
.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 < .001
for all). In total, 3 patients could not return to artistic activities as
the result of 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 their activities with a high success rate.
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