LaValva Scott M, LeBrun Drake G, Canoles Haley G, Ren Renee, Padgett Douglas E, Su Edwin P
Adult Reconstruction and Joint Replacement Service, Hospital for Special Surgery, New York, New York, USA.
Bone Joint J. 2024 Mar 1;106-B(3 Supple A):17-23. doi: 10.1302/0301-620X.106B3.BJJ-2023-0854.R1.
Professional dancers represent a unique patient population in the setting of hip arthroplasty, given the high degree of hip strength and mobility required by their profession. We sought to determine the clinical outcomes and ability to return to professional dance after total hip arthroplasty (THA) or hip resurfacing arthroplasty (HRA).
Active professional dancers who underwent primary THA or HRA at a single institution with minimum one-year follow-up were included in the study. Primary outcomes included the rate of return to professional dance, three patient-reported outcome measures (PROMs) (modified Harris Hip Score (mHHS), Hip disability and Osteoarthritis Outcome Score for Joint Replacement (HOOS-JR), and Lower Extremity Activity Scale (LEAS)), and postoperative complications.
A total of 49 hips in 39 patients (mean age 56 years (SD 13); 80% female (n = 39)) were included. Mean follow-up was 4.9 years (SD 5.1). Of these 49 hips, 37 THAs and 12 HRAs were performed. In all, 96% of hips returned to professional dance activities postoperatively. With regard to PROMs, there were statistically significant improvements in mHHS, HOOS-JR, and LEAS from baseline to ≥ one year postoperatively. There were complications in 7/49 hips postoperatively (14%), five of which required revision surgery (10%). There were no revisions for instability after the index procedure. Two complications (5.4%) occurred in hips that underwent THA compared with five (42%) after HRA (p = 0.007), though the difference by procedure was not significantly different when including only contemporary implant designs (p = 0.334).
Active professional dancers experienced significant improvements in functional outcome scores after THA or HRA, with a 96% rate of return to professional dance. However, the revision rate at short- to mid-term follow-up highlights the challenges of performing hip arthroplasty in this demanding patient population. Further investigation is required to determine the results of THA versus HRA using contemporary implant designs in these patients.
鉴于职业舞者的职业需要高度的髋关节力量和活动度，他们在髋关节置换手术中代表了一类独特的患者群体。我们试图确定全髋关节置换术（THA）或髋关节表面置换术（HRA）后职业舞者的临床结局以及恢复职业舞蹈的能力。
本研究纳入了在单一机构接受初次THA或HRA且随访至少一年的现役职业舞者。主要结局包括恢复职业舞蹈的比例、三项患者报告结局指标（PROMs）（改良Harris髋关节评分（mHHS）、关节置换的髋关节残疾和骨关节炎结局评分（HOOS-JR）以及下肢活动量表（LEAS））和术后并发症。
共纳入39例患者的49个髋关节（平均年龄56岁（标准差13）；80%为女性（n = 39））。平均随访时间为4.9年（标准差5.1）。在这49个髋关节中，进行了37例THA和12例HRA。总体而言，96%的髋关节术后恢复了职业舞蹈活动。关于PROMs，从基线到术后≥一年，mHHS、HOOS-JR和LEAS均有统计学意义的改善。术后49个髋关节中有7个出现并发症（14%），其中5个需要翻修手术（10%）。初次手术后没有因不稳定而进行翻修的情况。THA术后有2例并发症（5.4%），而HRA术后有5例（42%）（p = 0.007），不过仅纳入当代植入物设计时，不同手术方式的差异无统计学意义（p = 0.334）。
现役职业舞者在接受THA或HRA后功能结局评分有显著改善，恢复职业舞蹈的比例为96%。然而，短期至中期随访的翻修率凸显了在这类高要求患者群体中进行髋关节置换手术的挑战。需要进一步研究以确定在这些患者中使用当代植入物设计时THA与HRA的结果。
