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Oct 06, 2020 / Research & Innovation

Kids Aren't Just Small Adults - A Study Looking at a Growing Concern in Adolescent Hips

Many adolescents present to our team with hip conditions. One common condition in this population is femoroacetabular (FAI) impingement, a condition that involves a change in the shape of the hip joint. Particularly in athletes or active children, repetitive motions can cause changes in the bones or damage the soft tissue (labrum). The misshapen bones can pinch off the soft tissue and cause pain. The bony abnormalities can develop in the ball (head of the femur) or the socket (acetabulum) side of this flexible joint.

In an adult, a specific radiographic measurement has been shown to help predict the patient’s outcomes and the severity of damage that will be observed during hip surgery. Pediatric orthopedic surgeon Henry B. Ellis, M.D., has a particular interest in treating the hip in young athletes. He says, “There is less scientific evidence for the adolescent population with hip pain that may be associated with FAI.

To address this, the study team looked at data from nearly 10 years of adolescent (ages 10 – 21) patients with FAI seen at Scottish Rite for Children. This study included mostly female (74%) patients and very active patients (86%) who reported some sports participation. The review included patient reported outcome (PRO) questionnaires, radiographic measurement, called alpha angle, and surgical measurements. Though the results of the one study cannot completely answer the question, a few things were noted:
  • Larger alpha angle is correlated with amount of labral damage noted in surgery. Larger angles were correlated with worse damage.
  • Patient responses to questions about symptoms or severity DID NOT correlate with the damage. Worse scores were not correlated with worse damage.
  • Patients who underwent this surgery had improved outcomes after surgery. Scores on PROs were better after surgery than before.
Lead investigator, Tyler Youngman, M.D., says, “This information can help with providing better, evidence-based information to patients prior to surgery. This study is a look back at prior patients and gives great direction for future studies.” More research may help to further understand how timing of the intervention and surgery may improve the patients’ outcomes presumably by prevention further damage to the labrum and bones.

The study, “Alpha Angle is Associated with Severity of Labral Tear in Adolescent Athletes,” was selected to be presented at the American Academy of Pediatrics Annual Meeting 2020. Tyler Youngman, M.D., is a fourth-year orthopedic surgery resident at UT Southwestern Medical School in Dallas, Texas. He worked on this project with several of our pediatric orthopedic hip specialists and other Scottish Rite for Children staff as part of his academic experience.

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