Nonoperative Management of Labral Tears of the Hip in Adolescent Athletes: Description of Sports Participation, Interventions, Comorbidity, and Outcomes.

CONTEXT: Hip injury among young athletes is increasing, especially hip labral tears. Some tears may require surgical intervention, especially if they are associated with boney pathology such as femoroacetabular impingement (FAI). A protocol for nonoperative treatment of the hip labral tears is not well established. OBJECTIVE: To identify current nonoperative treatment options, comorbidities, sports participation, and outcomes of adolescent athletes who were diagnosed with hip labral tears. STUDY DESIGN: Retrospective chart review. SETTING: A regional tertiary level medical and academic institution. PARTICIPANTS: Physically active 8- to 20-year-old males and females who were diagnosed with hip labral tears in 2010 to 2013. MAIN OUTCOME MEASURES: Nonoperative treatment interventions including physical therapy (PT), intraarticular injection (IAI), the type of sports participation, and comorbidity were extracted. STATISTICAL ANALYSIS: Descriptive statistics and χ tests were used with a priori alpha level <0.05. RESULTS: Among 76 adolescent athletes who were diagnosed with hip labral tear, 52 (68.4%) had PT, 55 (72.4%) received IAI, and 43 (56.6%) experienced both PT and IAI interventions. Top 3 sports participated were dance (18.4%), soccer (14.5%), and gymnastics (7.9%). The most common comorbidity was FAI, which was observed in 46 individuals (60.5%). Although there was no difference in a proportion of FAI cases between sexes, a greater proportion of surgical cases were observed among hip labrum-injured athletes with FAI compared with those without FAI (P = 0.032). CONCLUSIONS: Adolescent athletes with hip labral tears often receive PT, IAI, and a combination of both, as nonoperative treatment options in this study cohort. The adolescent athletes who sustained hip labral tears with comorbidity of FAI had significantly greater proportion of surgical cases after nonoperative treatments.

Ultrasound examination and patellar tendinopathy scores in asymptomatic college jumpers.

OBJECTIVE: To investigate the prevalence of hypoechoic areas by US and its' association with VISA-P scores among asymptomatic jumpers while highlighting sex comparisons. DESIGN: Cross-sectional study. SETTING: Pre-participation exam at a National Collegiate Athletic Association (NCAA) division I college. PARTICIPANTS: Thirty-one college athletes who engage in jumping sports. MAIN OUTCOME MEASURES: Hypoechoic images of patellar tendon captured by ultrasound examination were compared to a self-reported knee functional survey, the Victorian Institute of Sport Assessment for patellar tendinopathy (VISA-P) scale (0-100). RESULTS: With a total of 31 athletes (13 males and 18 females), prevalence rate of the hypoechoic areas of patellar tendon was 19.4% (6/31) in the right knee and 29.0% (9/31) in the left knee. There was no proportional difference in a comparison of prevalence rate of hypoechoic area [(+) or (-)] by sex in either right or left knee. The VISA-P scores were significantly lower in US (+) than US (-) in the right knee (p = 0.003, Cohen's d = 1.675), but not the left knee (p = 0.250, Cohen's d = 0.512). The receiver operating characteristics curve analysis indicated the most sensitive and specific VISA-P values based on status [(+) or (-)] of hypoechoic area was 89.5 with 86.4% and 77.7% of sensitivity and specificity. CONCLUSION: In short, hypoechoic areas were detected by US examination among self-reported asymptomatic jumpers. There was an association between hypoechoic areas and VISA-P scores in the right knee, but not in left knee. VISA-P scores may be used as a screening tool for the presence of hypoechoic areas.