Purpose
To understand why professional female ballet dancers often complain of inguinal pain
and experience early hip osteoarthritis (OA). Goals were to examine clinical and advanced
imaging findings in the hips of dancers compared with those in a matched cohort of
nondancers and to assess the femoral head translation in the forward split position
using magnetic resonance imaging (MRI).
Methods
Twenty professional female ballet dancers and 14 active healthy female individuals
matched for age (control group) completed a questionnaire on hip pain and underwent
hip examination with impingement tests and measurement of passive hip range of motion
(ROM). All had a pelvic 1.5 T MRI in the back-lying position to assess femoroacetabular
morphologic features and lesions. For the dancers, additional MR images were acquired
in the split position to evaluate femoroacetabular congruency.
Results
Twelve of 20 dancers complained of groin pain only while dancing; controls were asymptomatic.
Dancers' passive hip ROM was normal. No differences in α neck angle, acetabular depth,
acetabular version, and femoral neck anteversion were found between dancers and controls.
MRI of dancers while performing splits showed a mean femoral head subluxation of 2.05
mm. MRI of dancers' hips showed labral tears, cartilage thinning, and herniation pits,
located in superior and posterosuperior positions. Lesions were the same for symptomatic
and asymptomatic dancers. Controls had proportionally the same number of labral lesions
but in an anterosuperior position. They also had 2 to 3 times fewer cartilage lesions
and pits than did dancers.
Conclusions
The results of our study are consistent with our hypothesis that repetitive extreme
movements can cause femoral head subluxations and femoroacetabular abutments in female
ballet dancers with normal hip morphologic features, which could result in early OA.
Pathologic changes seen on MRI were symptomatic in less than two thirds of the dancers.
Level of Evidence
Level IV, therapeutic case series.
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Article info
Publication history
Published online: January 18, 2013
Accepted:
October 16,
2012
Received:
January 6,
2012
Footnotes
The authors report the following potential conflict of interest of source of funding in relation to this article: N.M.-T. received compensation from the European Union for the “3D Anatomical Project.”
Recipient of the Achilles Orthopaedic Sports Medicine Award at the Eighty Biennial ISAKOS Congress in Rio de Janeiro, Brazil, May 15-19, 2011.
Identification
Copyright
© 2013 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
