Editorial Commentary: The Competitive Dancer's Hip-An Acquired Flexible Attitude to a High-Performance Hip

Competitive dancers have a high prevalence of hip injuries. The dancer's hip is a unique scenario in which hip impingement is associated with compensatory soft-tissue laxity. Particularly in these athletes, normal osseous hip morphology with symptomatic femoroacetabular impingement may be observed. The repetitive training, including extreme daily hip range of motion, results in compensatory soft-tissue laxity and secondary impingement-induced subluxation. Peculiarly, hip impingement in dancers occurs in the posterosuperior aspect of the hip and extra-articularly between the anterior inferior iliac spine and the distal femoral neck (subspinous impingement). Normal or even dysplastic hips might impinge during extreme range of motion. An atypical osteochondroplasty, including a subtle distal-based femoral resection, anterior inferior iliac spine decompression, and excellent management of the capsule, should be considered in this population for a successful outcome. Hip dysplasia should always be ruled out in these athletes, and if present, a periacetabular osteotomy should be indicated.