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Hip Dysplasia and Labral Degeneration

Hip Dysplasia and Labral Degeneration. Jackie Boss. Case Study. 19 y.o . female D1 lacrosse player CC - soreness and “pulling in her adductors” No specific MOI Insidious groin pain over the past 18 months Assessment: Hip d ysplasia with labral degeneration. Normal Hip X-Ray.

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Hip Dysplasia and Labral Degeneration

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  1. Hip Dysplasia and Labral Degeneration Jackie Boss

  2. Case Study • 19 y.o. female D1 lacrosse player • CC- soreness and “pulling in her adductors” • No specific MOI • Insidious groin pain over the past 18 months • Assessment: Hip dysplasia with labral degeneration

  3. Normal Hip X-Ray The femoral head fits firmly into the acetabulum

  4. Hip Dysplasia There is significant space between the acetabulum and femoral head

  5. Labral Tear The unclear white lined borders indicate tears in the acetabularlabrum

  6. Clinical Findings for Labral Tears Due to Hip Dysplasia • MOI: Repetitive microtraumafrom pivoting or twisting • These movements associated a lot with Lacrosse • Pain, clicking, locking, catching, instability, giving way, and/or stiffness • Most commonly referred pain to anterior groin • +FABER test, +Scour test, +Resisted SLR

  7. Clinical Reasoning of Labral Tears due to Hip Dysplasia • Dysplasia has shallow acetabulum on x-ray • Shallow acetabulum decreases bony stability, which increases mobility • The more mobility, the more abnormal stresses are placed on the surrounding soft tissue; both contractile and inert • More stressed placed on joint tissues contributes to hypermobility and possibility for labral tears

  8. Key Clinical Rehabilitation Points of Case Study • Labral tears typically occur due to weak core/ hip musculature that isn’t controlled during movement • Leads to abnormal shearing forces on the hip joint and increased femoral head translation on the labrum increases the chance for a tear • Check for anatomical differences on X- ray before diagnosing strictly a labral tear • Nonsurgical treatment isn’t the best rehabilitation for dysplastic labral tears • Didn’t make any progress, and symptoms increased with hip and core strengthening • Weight bearing is extremely limited the first 4 weeks after surgery to protect the repaired labrum

  9. References 1) Stalzer S, Wahoff M, Scanlan M. Rehabilitation following hip arthroscopy. Clin Sports Med. 2006;337-357. 2) Garrison JC, Osler MT, Singleton SB. Rehabilitation after arthroscopy of an acetabular labral tear. N Am J Sports Phys Ther. 2007;241-250. 3) Enseki KR, Martin RL, Draovitch P et al. The hip joint: Arthroscopic procedures and postoperative rehabilitation. J Orthop Sports Phys Ther. 2006;36(7):516-525.

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