IADMS New York 2002   [back to the Category]

The Role Of Hip Arthroscopy in Dancers with Acetabular Labral Tears and Their Rehabilitation   [read the french version]

Author :   Brent Anderson, PT, OCS & Al.

The Role Of Hip Arthroscopy in Dancers with
Acetabular Labral Tears and Their Rehabilitation.


Brent Anderson, PT, OCS
Polestar Education, Balanced Body, University of Miami
Miami, Florida, USA

Marc Phillipon, MD
Orthopedic Center, Holy Cross Medical Group
Pittsburgh, Pennsylvania, USA

Introduction: Hip arthroscopy is an expanding surgical Procedure. Treatment of acetabular labral tears is a clear indication for this procedure. Instrumentation has been a source of limitation in the past to gain access in all parts of the hip joint making arthroscopic management more difficult. The introduction of flexible instrumentation has made the management of these lesions more effective and safe. This presentation will focus on the interdisciplinary approach of an orthopaedic surgeon and a physical therapist using progressive approaches in both disciplines to aide in the treatment of dancers with internal derangements of the labrum and to prevent degenerative changes thought to lead to disability.


Methods: Three dancers had hip arthroscopies have been performed between May 2001 and November 2001. Acetabular labral tears were treated with arthroscopic partial limbectomy in patents with disabling hip symptoms of more than six months. The torn portion of the labrum was debrided back to stable labral remnant utilizing motorized shavers and flexible radio frequency probes. The three professional dancers were rehabilitated using Pilates Evolved Rehabilitation. The rehabilitation was divided into three stages of intervention, each with specific limitations and criteria before moving on to the next level. Stage one was during the non-weight and partial-weight bearing stages, avoiding external rotation, while maintaining movement in the sagittal plane. Stage two included full weight bearing with 50% active range of motion in external and internal rotation. Stage three included full weight bearing and full ranges of motion of the hip with greatest emphasis on functional activity. The Pilates environment provides an optimum setting to facilitate the progression immediately following surgery. Pilates focuses on alignment and coordination.

Results: All three returned to full dance activity. One continues with a minimal complaint of anterior hip pain, usually associated with fatigue.

Conclusion: Hip arthroscopy is a minimally invasive surgical procedure and has a high success rate in properly selected patients, more specifically for the treatment of acetabular labral tears. The introduction of flexible cutting probes and shrinkage probes appear to improve the effectiveness and safety of the procedure. The physical therapy on the Pilates, appears to be beneficial as well and the short-term results are encouraging.