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New femoroacetabular impingement seen in ballet dancers raises some questions
Femoroacetabular impingement data did not help explain why some ballet dancers had groin pain in extreme positions, while others were asymptomatic.
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GENEVA — Some ballet dancers presented with painful inguinal pain from labral or cartilage lesions that occurred after extreme hip movements, while others with those same lesions were asymptomatic, according to a study presented at the European Society of Sports Traumatology, Knee Surgery and Arthroscopy Congress 2012, here.
Victoria B. Duthon, MD, and colleagues identified 20 adolescent professional ballet dancers with normal hip morphology and range of motion and compared them to a control group of 15 asymptomatic women of the same age.
MRI results for the dancers showed that in a split position, 90% had labral or cartilage lesions located in the superior or postero-superior part of the acetabular rim.
Victoria B. Duthon
“Dancers have typical femoroacetabular impingement [FAI] lesions, but with normal hip morphology and in superior [and] posterior-superior positions,” Duthon said. “After given time to indicate for revisions, [and given] the symptoms and the lesions we found on MRI, we all should be aware of our surgical indications with dancers.”
MRI, motion capture studies
Twelve ballet dancers complained of hip pain while dancing; seven dancers had pain on the right side; one dancer had pain on the left side, and four dancers had bilateral pain, according to the results.
The women studied completed a FAI questionnaire, had MRI done while lying on their back and while doing splits, were examined for anterior impingement and underwent passive hip range of motion (ROM) measurements.
MRI reconstructions show femoroacetebular impingement on the femoral neck (top) and superior/posterior actetabular rim (bottom).
Images: Duthon VB
Duthon and colleagues used motion capturing to track the dancers’ movements and the software was able to “demonstrate this dance-related ‘FAI’ in vivo,” Duthon said.
Inconsistent clinical, MRI results
The number of labral lesions was the same for the control group and the group with groin pain. However, the asymptomatic control group had two to three times fewer cartilage lesions and pits associated with the anterior-superior position compared to the dancers, she said.
The dancers had what was considered normal hip ROM, but with a trend toward increased flexion, external rotation and abduction compared with the controls, according to Duthon.
The amount of FAI subluxation for the dancers was 2.05 mm. There were no differences in acetabular anteversion or depth between the dancers and control subjects, and only one dancer had femoral neck antetorsional cam-type morphology, according to the abstract.
Duthon said the data collected in her investigation could not help the team make any conclusions about why the clinical and MRI results between the groups were so different, but the study showed that dancers have a dynamic, dance-related FAI. – by Jeff Craven
Reference:
- Duthon VB, Charbonnier C, Christophe FK, et al. Correlation of clinical and MRI findings in professional dancers’ hip: A new femoroacetabular impingement? Paper #FP29-650. Presented at the European Society of Sports Traumatology, Knee Surgery and Arthroscopy Congress 2012. May 2-5. Geneva.
For more information:
- Victoria B. Duthon, MD, can be reached at the Department of Orthopaedic Surgery, University Hospital of Geneva, 24 rue Micheli-du-Crest, 1211, Geneva, Switzerland; email: victoria.duthon@hcuge.ch.
- Disclosure: Duthon has no relevant financial disclosures.