Hip Microinstability Associated with Subclinical Femoroacetabular Impingement in a Ballet Dancer: A Case Report

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Abstract

Background. Ballet dancers have peculiarities in the morphology of the hip joints, which is determined by their professional activities. Therefore, they are more susceptible to the development of pathological conditions of joints, which often present a specific clinical picture.

The aim is to demonstrate a rare structural damage to the hip joint capsule and iliofemoral ligament in a ballet dancer.

Case description. The patient is a 32-year-old professional ballet dancer. She noted pain and limited range of motion in the right hip joint during her dance classes. Radiologic examination methods identified minimal anatomical features characteristic of femoroacetabular impingement, and damages to the acetabular labrum and structures of the anterior joint capsule. Pain and functional status were assessed using the VAS, HOOS, iHOT-12 questionnaires before surgery and at 6, 12, 18, 24, 36 and 48 months postoperatively. During the surgery, correction of bone deformity of the hip joint and all identified soft-tissue damages was successfully carried out. After 5 months, the patient returned to her professional activities. According to the VAS score, pain decreased from 6 points to 0 at the follow-up time points. At the same time a periodic slight aching pain after physical activities remained. During the follow-up, the functional status was assessed as excellent according to the HOOS and iHOT-12 questionnaires. However, the patient noted slight limitations in the range of motion when performing some professional exercises.

Conclusions. The presented clinical case demonstrates that patients with hip pain whose professional activity is associated with extreme hip range of motion require special attention during clinical provocative tests and critical evaluation of effective measurements when compared with the reference values of radiologic examination methods. In the present case, arthroscopic correction of structural damages made it possible to achieve excellent functional results through the planning and performance of surgical intervention taking into account the concept of microinstability.

About the authors

Sergey A. Gerasimov

Privolzhsky Research Medical University; “Orthopaedic Research Projects”

Email: gerasimoff@list.ru
ORCID iD: 0000-0002-3179-9770

Cand. Sci. (Med.)

Russian Federation, Nizhny Novgorod; Nizhny Novgorod

Ekaterina A. Morozova

Privolzhsky Research Medical University; “Orthopaedic Research Projects”

Author for correspondence.
Email: ekaterina.m.96@mail.ru
ORCID iD: 0000-0001-7548-9398
Russian Federation, Nizhny Novgorod; Nizhny Novgorod

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Supplementary files

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2. Figure 1. Preoperative X-rays with the measurements of: a — Wiberg’s angle; b —  angle

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3. Figure 2. Preoperative MRI scans: a — coronary section T1; b — sagittal section T1

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4. Figure 3. Results of functional status assessment at the follow-up time points

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