Assessment of Congruence and Impingement of the Hip Joint in Professional Ballet Dancers

Charbonnier, Caecilia; Kolo, Frank; Duthon, Victoria B.; Magnenat‐Thalmann, Nadia; Becker, Christoph; Hoffmeyer, Pierre; Ménétrey, Jacques

doi:10.1177/0363546510386002

Cited by 158 publications

(147 citation statements)

References 33 publications

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“…Understanding kinematic attributes described by Lamontagne et al [10], Kennedy et al [9], and Charbonnier et al [4,5], it is conceivable that these motions, performed in hips with restricted flexion, can induce shear stresses on the femoral head that can produce the pathologic changes reported here. Whether the specified motions produce shear stresses by causing transient subluxation or forceful nonconcentric motion on the femoral head remains uncertain.…”

Section: Discussionmentioning

confidence: 59%

“…Similarly, Kennedy et al [9] demonstrated decreased peak hip abduction, decreased frontal ROM, and attenuated pelvic roll in cam-type FAI compared with controls. In a novel motion capture analysis performed in a professional ballet dancer with normal hips, Charbonnier et al [4,5] demonstrated transient subluxation of the hip in certain ballet positions, especially those involving abduction and external rotation in maximum flexion. These findings suggest translational hip motion is associated with FAI.…”

Section: Introductionmentioning

confidence: 99%

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Parafoveal Chondral Defects Associated with Femoroacetabular Impingement

Zaltz¹,

Leunig

2012

Clinical Orthopaedics &Amp; Related Research

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Background Cam-type, pincer, and mixed femoroacetabular impingement (FAI) are accepted causes of labral and acetabular rim injury; however, the abnormal contact stresses associated with motion may damage other areas of the hip. Although cartilage damage to the femoral head has been reported previously in athletes, FAI-associated focal parafoveal chondral defects differ from previously reported lesions and represent a rare manifestation of the complex pathomechanics associated with FAI.

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Section: Discussionmentioning

confidence: 59%

Section: Introductionmentioning

confidence: 99%

Parafoveal Chondral Defects Associated with Femoroacetabular Impingement

Zaltz¹,

Leunig

2012

Clinical Orthopaedics &Amp; Related Research

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“…These extreme positions seem to be responsible for a "pincer-like" mechanism of impingement, with linear contact between the superior or posterosuperior acetabular rim and the femoral head-neck junction. This mechanism has been demonstrated by Charbonnier et al [16,17], who assessed, dynamically, dancers' hip joint motions. Dynamic data were collected by these authors, while the professional dancers were performing six dancing movements: arabesque, développé devant, développé à la seconde, grand écart facial, grand écart latéral, and grand plié.…”

Section: Discussionmentioning

confidence: 74%

“…As reported in Gilles et al [14], the MRI data acquired with the dancers in the splits position showed for the 59 hips a mean femoroacetabular subluxation of 2.05 mm (range 0.63-3.56 mm). The magnitude of subluxation during the dancing movements assessed by Charbonnier et al [16,17] was even greater (peak value = 6.32 mm). We can thus suppose that the lost of joint congruency exposes the dancers' hips cartilage to stress, which also favors cartilage lesions.…”

Section: Discussionmentioning

confidence: 89%

Extreme hip motion in professional ballet dancers: dynamic and morphological evaluation based on magnetic resonance imaging

et al. 2012

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Objective To determine the prevalence of femoroacetabular impingement (FAI) of the cam or pincer type based on magnetic resonance imaging (MRI) in a group of adult female professional ballet dancers, and to quantify, in vivo, the range of motion (ROM) and congruence of the hip joint in the splits position. Materials and methods Institutional review board approval and informed consent from each volunteer were obtained. Thirty symptomatic or asymptomatic adult female professional ballet dancers (59 hips) and 14 asymptomatic non-dancer adult women (28 hips, control group) were included in the present study. All subjects underwent MRI in the supine position, while, for the dancers, additional images were acquired in the splits position. Labral abnormalities, cartilage lesions, and osseous abnormalities of the acetabular rim were assessed at six positions around the acetabulum. A morphological analysis, consisting of the measurement of the α angle, acetabular depth, and acetabular version, was performed. For the dancers, ROM and congruency of the hip joint in the splits position were measured.Results Acetabular cartilage lesions greater than 5 mm were significantly more frequent in dancer's hips than in control hips (28.8 vs 7.1%, p=0.026), and were mostly present at the superior position in dancers. Distribution of labral lesions between the dancers and the control group showed substantially more pronounced labral lesions at the superior, posterosuperior, and anterosuperior positions in dancers (54 lesions in 28 dancer's hips vs 10 lesions in 8 control hips). Herniation pits were found significantly more often (p=0.002) in dancer's hips (n=31, 52.5%), 25 of them being located in a superior position. A cam-type morphology was found for one dancer and a retroverted hip was noted for one control. Femoroacetabular subluxations were observed in the splits position (mean: 2.05 mm). Conclusion The prevalence of typical FAI of the cam or pincer type was low in this selected population of professional ballet dancers. The lesions' distribution, mostly superior, could be explained by a "pincer-like" mechanism of impingement with subluxation in relation to extreme movements performed by the dancers during their daily activities.

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“…While most agree acetabular chondral delamination occurs as a result of shear forces created by the cam deformity [11,23,29,40,46,50,56,62], the cause of defects occurring remotely to the cam or pincer deformity is subject to more speculation. Charbonnier et al [12] demonstrated impingement and secondary femoral head subluxation in dancers with morphologically normal hips, and two studies have demonstrated decreased hip flexion and abduction in patients with FAI [33,36]. It may be that patients participating in sports or vocations that require deeper, forceful, or repetitive hip flexion and rotation subject their cartilage to similar episodes of dynamic instability secondary to their impingement [6].…”

Section: Discussionmentioning

confidence: 99%

Surgical Technique: Second-generation Bone Marrow Stimulation via Surgical Dislocation to Treat Hip Cartilage Lesions

Leunig

Tibor

Naal

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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Assessment of Congruence and Impingement of the Hip Joint in Professional Ballet Dancers

Abstract: The present study indicates that some dancing movements could damage the hip joint, which could lead to early osteoarthritis.

Cited by 158 publications

References 33 publications

Parafoveal Chondral Defects Associated with Femoroacetabular Impingement

Parafoveal Chondral Defects Associated with Femoroacetabular Impingement

Extreme hip motion in professional ballet dancers: dynamic and morphological evaluation based on magnetic resonance imaging

Surgical Technique: Second-generation Bone Marrow Stimulation via Surgical Dislocation to Treat Hip Cartilage Lesions

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