Purpose
To investigate the rate of return to dance and factors influencing this primary outcome
after hip arthroscopy for the treatment of femoroacetabular impingement syndrome.
Methods
A consecutive series of self-identified dancers with femoroacetabular impingement
syndrome was included. To assess for the impact of hypermobility on outcomes, patients
were classified as having either generalized joint laxity (GJL) or no GJL based on
the Beighton-Horan Joint Mobility Index. A return-to-dance survey, the modified Harris
Hip Score, and the Hip Outcome Score (HOS)–Activities of Daily Living and HOS–Sports-Specific
subscales were collected preoperatively and postoperatively at 6, 12, 24, and 36 months.
The preoperative-to-postoperative outcome score change was compared using the minimal
clinically important difference and patient acceptable symptomatic state. Return to
dance was evaluated regarding (1) return to any dance activity, (2) return to prior
level of dance, and (3) number of hours of dance participation after surgery. Clinical
and demographic predictors and return to dance were analyzed using univariate or bivariate
analysis where appropriate.
Results
The study included 64 consecutive dancers (62 female and 2 male patients) (mean age,
22.3 ± 9.4 years; body mass index, 22.8 ± 4.1) with a mean follow-up period of 23.0 months.
Postoperatively, 62 patients (97%) returned to dance at an average of 6.9 ± 2.9 months;
40 patients (62.5%) reported that they returned to a better level of participation,
whereas 20 dancers (31%) returned to the same level of participation. Statistically
significant increases were observed for the HOS–Activities of Daily Living subscale
(60.5 ± 19.5 vs 92.4 ± 11.8, P < .001), HOS–Sports-Specific subscale (40.3 ± 20.3 vs 83.5 ± 19.4, P < .001), and modified Harris Hip Score (57.0 ± 13.6 vs 86.6 ± 13.9, P < .001). There was, however, a significant decrease in the number of hours of dance
postoperatively: 11.5 ± 8.2 h/wk preoperatively versus 9.0 ± 7.3 h/wk postoperatively
(P = .041). All postoperative hip outcome measures showed statistically significant
(P < .001) and clinically relevant improvements. Patient-reported outcomes and return
time showed no significant differences between the patient groups with GJL and without
GJL (P = .1 and P = .489, respectively). For competitive dancers, a correlation was shown with a shorter
time to return to dance (r2 = 0.45, P = .001), but there were no significant differences by skill level in patient-reported
outcomes or dance hours.
Conclusions
After hip arthroscopy, 97% of dancers returned to dance at an average of 6.9 months,
with most dancers dancing at a level higher than their preoperative status. Dance
experience level was the only significant factor influencing return-to-dance outcomes,
with competitive dancers showing a faster return to dancing.conclusion
Level of Evidence
Level IV, therapeutic case series.
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Article Info
Publication History
Published online: March 08, 2019
Accepted:
October 24,
2018
Received:
July 21,
2018
Footnotes
The authors report the following potential conflicts of interest or sources of funding: B.R.W. is a board/committee member of the American Academy of Orthopaedic Surgeons, Arthroscopy Association of North America, and Society of Military Orthopaedic Surgeons; serves on the editorial/governing board of the American Journal of Orthopedics and Arthroscopy; receives publishing royalties and financial/material support from Elsevier ; and is a paid presenter/speaker for Genzyme. J.D.H. is a board or committee member of the American Academy of Orthopaedic Surgeons, American Association of Oral and Maxillofacial Surgeons, and Arthroscopy Association of North America; serves on the editorial or governing board of Arthroscopy and Frontiers in Surgery; receives research support from DePuy , A Johnson & Johnson Company; is a paid consultant for NIA Magellan; is a paid consultant and paid presenter or speaker for Ossur; receives publishing royalties and financial or material support from SLACK ; and is a paid consultant and paid presenter or speaker for and receives research support from Smith and Nephew . S.J.N. receives research support from AlloSource , Arthrex , Athletico , DJ Orthopaedics , Linvatec , Miomed , Smith & Nephew, and Stryker; serves on the editorial/governing board of the American Journal of Orthopedics; is a board/committee member of the American Orthopaedic Society for Sports Medicine and Arthroscopy Association of North America; receives IP royalties from and is a paid consultant for Ossur; and receives publishing royalties and financial/material support from Springer . Full ICMJE author disclosure forms are available for this article online, as supplementary material.
See commentary on page 1109
Identification
Copyright
© 2019 by the Arthroscopy Association of North America
