Former Rockette Lois Enders understands the importance of flexibility. A professional dancer from Fenton, Mo., who also performs at the Muny and with STAGES St. Louis, Enders has kept up an active career despite undergoing arthroscopy for hip pain.
“I first noticed that my hip hurt more than the usual aches and pains of a dancer when I came back from touring with the Rockettes in 2004,” says Enders. “I couldn’t perform certain stretches and do high kicks like I used to do.”
The hip pain continued to escalate over the next several months. Enders then sought an evaluation by Devyani Hunt, MD, a specialist in physical medicine and rehabilitation with Washington University Orthopedics, who has a special interest in performing arts medicine. A thorough exam revealed that Enders was suffering from a tear in the tissue circling the right hip socket. Called the labrum, the tissue is critical for smooth hip movement. If torn, the tissue often can become pinched in the joint, causing severe pain.
“Labral tears may be caused by trauma or an anatomical deformity that becomes worse as a person ages,” says Dr. Hunt. “It’s important that the tears are treated early, because if left untreated, many patients may ultimately have progressive hip problems.”
Enders was referred to Dr. Hunt’s colleague, John Clohisy, MD, a Washington University orthopedic surgeon who specializes in hip procedures. Dr. Clohisy recommended hip arthroscopy, a minimally invasive procedure designed to treat various problems in the hip joint.
“Hip arthroscopy has been performed for the last decade, but it’s become more common within the past five years as an effective treatment option,” says Dr. Clohisy. “It’s one of several procedures we perform that are considered joint preservation procedures.” Other joint preservation procedures include hip joint debridement, during which surgeons trim the bones around the hip joint to correct small abnormalities or to relieve bony impingements around the joint, and hip osteotomy, which repositions the hip socket itself or the top of the femur within the hip socket.
Enders was a perfect candidate for hip arthroscopy because although she had a labral tear, her hip joint was otherwise healthy. “It’s always better to maintain or repair a patient’s own natural hip joint. Joint preservation procedures are excellent options for many patients with early hip disease,” says Dr. Clohisy.
Treating the hip pain early also may prevent more serious complications farther down the road. “More than 95 percent of patients who eventually undergo hip replacement had a previous problem such as a labral tear or an anatomical issue that caused subsequent arthritis,” says Dr. Clohisy. “If you take care of the cause early enough, we have found that many patients are able to regain their function very quickly and they may also avoid the need for a hip replacement later.”
“I was very nervous about the outcome because if the pain didn’t go away, I really would have had to end my career as a dancer,” says Enders. She underwent hip arthroscopy in August of 2005 and went home on crutches the same day. Six months of physical therapy followed before Enders was cleared to take dance classes and test her range of motion.
“It took awhile before I could get back into ballet classes and I stayed off work for about a year, but I was able to perform at the Muny the following summer,” said Enders now travels each year with Irving Berlin’s White Christmas troupe.
“I’m glad I had the procedure,” she says. “The doctors explained everything to me and made me feel comfortable. I have to think about my dancing a bit more these days — how I use my hips and making sure I follow proper techniques and form — but I’m able to continue dancing and be flexible. It’s a great relief to know that I can keep doing what I love without pain.”