High Rates of Satisfaction and Return to Dance in Current or Former Professional Ballet Dancers After Total Hip Arthroplasty With a Muscle-Sparing Direct Anterior Approach Using Custom Femoral Stems.

Abstract

Professional ballet dancers have high expectations after total hip arthroplasty (THA), particularly if they intend to resume dancing as performers or teachers. To report clinical outcomes and return to dance after THA with a muscle-sparing direct anterior approach using a custom femoral stem in a cohort of current or former professional ballet dancers. Case series; Level of evidence, 4. Twenty-three patients (26 hips) were included, that identified as current or former professional ballet dancers, from a consecutive series of 1699 hips that underwent primary THA by 1 of 2 surgeons. Both surgeons routinely implanted custom femoral stems using a muscle-sparing direct anterior approach in active and/or high-demand patients. All patients completed a questionnaire postoperatively that assessed dance capabilities, the visual analog scale (VAS) for hip pain (0-10), the VAS for satisfaction with surgery (0-10), the Oxford Hip Score (OHS), and the Forgotten Joint Score (FJS). The initial cohort comprised 19 women and 4 men, with a mean age of 50.5 ± 14.9 years and a mean 38.0 ± 14.4 years of dance experience. One patient underwent revision THA for a leg-length discrepancy, leaving 22 patients (25 hips) with a mean follow-up of 3.4 ± 1.4 years. The mean VAS satisfaction score was 9.8 ± 0.6, and the mean VAS pain score was 0.5 ± 1.0. The postoperative OHS and FJS were 46 ± 2 and 92 ± 15, respectively. Overall, 16 patients resumed ballet at 5.1 ± 3.9 months, 3 resumed other types of dance, and 3 did not resume any type of dance. None of the 6 patients who did not resume ballet indicated pain in the operated hip as the reason for stopping. In current or former professional ballet dancers, THA by a muscle-sparing direct anterior approach using a custom femoral stem yielded excellent clinical outcomes at a minimum of 2 years, with the highest satisfaction score of 10 points reported for 88% of hips and 72% of hips being totally pain free. Furthermore, 73% of patients resumed ballet, and 86% resumed dance in general.