Advertisement

Hip Dysplasia in Athletes

  • Soshi UchidaEmail author
  • Dean K. Matsuda
  • Akinori Sakai
Chapter

Abstract

This chapter reviews how to manage hip dysplasia in athletes. Preoperative patient evaluation, radiographic assessment, and planning are paramount for successful treatment.

Despite several reports looking at the effectiveness of various surgical procedures to address the hip dysplasia in general, this book chapter focuses on its treatment in athletes. It has been reported that periacetabular osteotomy (PAO) can provide favorable clinical outcome and high rate of return to play in the setting of hip dysplasia. High-demand athletes with DDH appear to be suboptimal candidates for these conventional open approaches due to prolonged postoperative rehabilitation and unestablished ability to return to sports. The recent addition of endoscopic shelf acetabuloplasty extends the minimally invasive approach to athletes with mild-moderate DDH.

Keywords

Hip dysplasia Athlete Hip arthroscopy Endoscopic shelf acetabuloplasty 

References

  1. 1.
    Uchida S, Hatakeyama A, Kanezaki S, Utsunomiya H, Suzuki H, Mori T, et al. Endoscopic shelf acetabuloplasty can improve clinical outcomes and achieve return to sports-related activity in active patients with hip dysplasia. Knee Surg Sports Traumatol Arthrosc. 2018;26:3165.CrossRefGoogle Scholar
  2. 2.
    Charbonnier C, Kolo FC, Duthon VB, Magnenat-Thalmann N, Becker CD, Hoffmeyer P, et al. Assessment of congruence and impingement of the hip joint in professional ballet dancers: a motion capture study. Am J Sports Med. 2011;39(3):557–66.CrossRefGoogle Scholar
  3. 3.
    Fukushima K, Takahira N, Imai S, Yamazaki T, Kenmoku T, Uchiyama K, et al. Prevalence of radiological findings related to femoroacetabular impingement in professional baseball players in Japan. J Orthop Sci. 2016;21(6):821–5.CrossRefGoogle Scholar
  4. 4.
    Matsuda DK, Wolff AB, Nho SJ, Salvo JP Jr, Christoforetti JJ, Kivlan BR, et al. Hip dysplasia: prevalence, associated findings, and procedures from large multicenter arthroscopy study group. Arthroscopy. 2018;34(2):444–53.CrossRefGoogle Scholar
  5. 5.
    Uchida S, Utsunomiya H, Mori T, Taketa T, Nishikino S, Nakamura T, et al. Clinical and radiographic predictors for worsened clinical outcomes after hip arthroscopic labral preservation and capsular closure in developmental dysplasia of the hip. Am J Sports Med. 2016;44(1):28–38.CrossRefGoogle Scholar
  6. 6.
    Wiberg G. The anatomy and roentgenographic appearance of a normal hip joint. Acta Chir Scand. 1939;83(Suppl 58):7–38.Google Scholar
  7. 7.
    Chosa E, Tajima N. Anterior acetabular head index of the hip on false-profile views. New index of anterior acetabular cover. J Bone Joint Surg Br. 2003;85(6):826–9.CrossRefGoogle Scholar
  8. 8.
    Boster IR, Ozoude GC, Martin DE, Siddiqi AJ, Kuppuswami SK, Domb BG. Femoral anteversion in the hip: comparison of measurement by computed tomography, magnetic resonance imaging, and physical examination. Arthroscopy. 2012;28(5):619–27.CrossRefGoogle Scholar
  9. 9.
    Akiyama M, Nakashima Y, Fujii M, Sato T, Yamamoto T, Mawatari T, et al. Femoral anteversion is correlated with acetabular version and coverage in Asian women with anterior and global deficient subgroups of hip dysplasia: a CT study. Skelet Radiol. 2012;41(11):1411–8.CrossRefGoogle Scholar
  10. 10.
    Tonnis D, Heinecke A. Acetabular and femoral anteversion: relationship with osteoarthritis of the hip. J Bone Joint Surg Am. 1999;81(12):1747–70.CrossRefGoogle Scholar
  11. 11.
    Domb BG, Chaharbakhshi EO, Perets I, Yuen LC, Walsh JP, Ashberg L. Hip arthroscopic surgery with labral preservation and capsular plication in patients with borderline hip dysplasia: minimum 5-year patient-reported outcomes. Am J Sports Med. 2018;46(2):305–13.CrossRefGoogle Scholar
  12. 12.
    Hatakeyama A, Utsunomiya H, Nishikino S, Kanezaki S, Matsuda DK, Sakai A, et al. Predictors of poor clinical outcome following arthroscopic labral preservation, capsular plication and cam osteoplasty in the setting of borderline hip dysplasia. Am J Sports Med. 2017;46(1):135–43.CrossRefGoogle Scholar
  13. 13.
    van Bergayk AB, Garbuz DS. Quality of life and sports-specific outcomes after Bernese periacetabular osteotomy. J Bone Joint Surg Br. 2002;84(3):339–43.CrossRefGoogle Scholar
  14. 14.
    Ettinger M, Berger S, Floerkemeier T, Windhagen H, Ezechieli M. Sports activity after treatment of residual hip dysplasia with triple pelvic osteotomy using the Tonnis and Kalchschmidt technique. Am J Sports Med. 2015;43(3):715–20.CrossRefGoogle Scholar
  15. 15.
    Bogunovic L, Hunt D, Prather H, Schoenecker PL, Clohisy JC. Activity tolerance after periacetabular osteotomy. Am J Sports Med. 2014;42(8):1791–5.CrossRefGoogle Scholar
  16. 16.
    Heyworth BE, Novais EN, Murray K, Cvetanovich G, Zurakowski D, Millis MB, et al. Return to play after periacetabular osteotomy for treatment of acetabular dysplasia in adolescent and young adult athletes. Am J Sports Med. 2016;44(6):1573–81.CrossRefGoogle Scholar
  17. 17.
    Uchida S, Wada T, Sakoda S, Ariumi A, Sakai A, Iida H, et al. Endoscopic shelf acetabuloplasty combined with labral repair, cam osteochondroplasty, and capsular plication for treating developmental hip dysplasia. Arthrosc Tech. 2014;3(1):e185–e91.CrossRefGoogle Scholar
  18. 18.
    Uchida S, Pascual-Garrido C, Ohnishi Y, Utsunomiya H, Yukizawa Y, Chahla J, et al. Arthroscopic shoelace capsular closure technique in the hip using ultratape. Arthrosc Tech. 2017;6(1):e157–e61.CrossRefGoogle Scholar
  19. 19.
    Uchida S, Shimizu Y, Yukizawa Y, Suzuki H, Pascual-Garrido C, Sakai A. Arthroscopic management for acetabular rim stress fracture and osteochondritis dissecans in the athlete with hip dysplasia. Arthrosc Tech. 2018;7:e533.CrossRefGoogle Scholar
  20. 20.
    Yamada K, Matsuda DK, Suzuki H, Sakai A, Uchida S. Endoscopic shelf acetabuloplasty for treating acetabular large bone cyst in patient with dysplasia. Arthrosc Tech. 2018;7:e691.CrossRefGoogle Scholar

Copyright information

© ISAKOS 2019

Authors and Affiliations

  1. 1.Wakamatsu Hospital of the University of Occupational and Environmental HealthKitakyushuJapan
  2. 2.DISC Sports and SpineMarina Del ReyUSA
  3. 3.Department of Orthopaedic SurgeryUniversity of Occupational and Environmental HealthKitakyushuJapan

Personalised recommendations