Sclerosis Case Summary

BACKGROUND The patient is an 18-year-old female Division I collegiate golf player. The athlete’s chief complaint was pain, clicking and grinding in her hip region when walking. Her hip issues were congenital and led to the diagnosis of a hip labral tear. The patient’s hip issues were bilateral with the left hip being worse than the right. Before coming to X, she had pain and an affected gait from her hip. When she arrived atX, she saw a hip specialist and developed a plan for surgery. The patient had arthroscopic hip surgery for a labral repair, femoroplasty, acetabuloplasty, and capsular closure on her left hip in early August of 2014. DIFFERENTIAL DIAGNOSIS The differential diagnoses might include Legg-Calve-Perthes disease, femoral neck
stress syndrome, adductor muscle strain, or a femoral head stress fracture. TREATMENT Initial treatment as an 18-year-old included an MRI scan leading to the diagnosis of a hip labral tear. The patient received surgery as soon as she arrived to X. During surgery, the labral tear was repaired along with a femoroplasty, acetabuloplasty, and capsular closure. Hip rehabilitation and strengthening began immediately after surgery, starting with PROM and reducing pain, swelling, and ecchymosis. During this time, the patient received infrared laser therapy to help reduce the ecchymosis. She progressed to AROM after she was pain free with PROM. After AROM was relatively pain free, the athlete was able to incorporate strengthening exercises of each individual hip muscle, lower body, and her core.
Strengthening exercises began on the affected hip and then transitioned to bilateral. The athlete was able to begin sport specific training and putting mid December. The athlete’s eventual return to play was 8 months after surgery and was accompanied with hip maintenance. UNIQUENESS This injury is specifically unique to X because at the time of the injury, it was only LSU’s second hip labral tear and repair. The patient also had an intensive and prolonged rehabilitation. This injury is also unique because the patient is now experiencing similar symptoms in her other hip. She will need to have surgery on this hip now to repair the labrum. This particular case is unique as well because it is not due to a sport specific mechanism or incident, but is due to her genetics. CONCLUSION This case study observes a hip labral tear due to genetics leading up to its surgery and rehabilitation process. It will help those associated with treating patients with bilateral hip labral tears. The entire rehabilitation process from surgery to return to play was successful and to date she has had no further issues with the affected
hip.