Ultrasonography Of Femoral Acetabular Translation In Female Athletes Undergoing Hip Athroscopy

Abstract

BACKGROUND: Hip arthroscopy may be a risk factor for post-surgical microinstability, leading to ongoing pain. Dynamic hip ultrasonography (US) has shown to reliably measure femoral acetabular translation. Evidence regarding the effect of hip arthroscopy on femoral acetabular translation and subsequent stability is lacking, especially in female athletes. PURPOSE:> 1. To examine ultrasound measurements of femoral acetabular translation in female athletes. 2. To compare dynamic US measurements in female athletes who have undergone hip arthroscopy versus female athletes who have not. METHODS: Cross-sectional study design. Dynamic US examination of femoroacetabular joint translation was performed in three positions: neutral hip, neutral hip with contralateral hip in flexion, and apprehension position (extension external rotation) (d’Hemecourt et al, CORR, 2018). Variables include age, sex, BMI, Beighton score, acetabular coverage angles. Main outcome measure US measures (mm) of femoral acetabular translation. Multivariate analysis of covariance (MANCOVA) with p < 0.05 was used for statistical analysis. Independent variable hip arthroscopy vs. no hip arthroscopy. Covariates include Beighton scores and acetabular angles. RESULTS: 171 female athletes were included. Twenty-five female athletes underwent right hip arthroscopy, and 17 left hip arthroscopy. In the neutral position, mean femoral acetabular translation in arthroscopy patients was 2.11±2.10 mm compared to non-arthroscopy study athletes (1.76±1.99 mm; p=0.349). In the neutral with hip flexion position, translation of arthroscopy study athletes was greater when compared to translation in non-surgical study athletes (5.17±2.00 mm and 4.38±2.49 mm, respectively), with a trend toward significance (p=0.088). Arthroscopy female athletes showed greater translation in the apprehension position compared to non-surgical female athletes (6.33±2.37 mm, 5.39±2.37 mm, respectively; p=0.042). CONCLUSION: Female athletes undergoing hip arthroscopy demonstrated differences in femoral acetabular translation via dynamic US when compared to female non-surgical patients while accounting for acetabular coverage and ligamentous laxity. Continued investigation of hip stability using dynamic US and future clinical utility is warranted.