Hip-related groin pain, patient characteristics and patient-reported outcomes in patients referred to tertiary care due to longstanding hip and groin pain: a cross-sectional study

Abstract

Background Due to advances in hip arthroscopy, the number of surgical procedures has increased dramatically. The diagnostic challenge in patients with longstanding hip and groin pain, as well as the increasing number of hip arthroscopies, may lead to a higher number of patients referred to tertiary care for consideration for surgery. Therefore, the aims were: 1) to describe the prevalence of hip-related groin pain in patients referred to tertiary care due to longstanding hip and groin pain; and 2) to compare patient characteristics and patient-reported outcomes for patients categorized as having hip-related groin pain and those with non-hip-related groin pain. Methods Eighty-one patients referred to the Department of Orthopedics at Skåne University Hospital for longstanding hip and groin pain were consecutively included and categorized into hip-related groin pain or non-hip-related groin pain using diagnostic criteria based on current best evidence (clinical examination, radiological examination and intra-articular block injection). Patient characteristics (gender (%), age (years), BMI (kg/m2)), results from the Hip Sports Activity Scale (HSAS), the SF-36, the Copenhagen Hip and Groin Outcome Score (HAGOS), and pain distribution (pain manikin) were collected. Parametric and non-parametric statistics were used as appropriate for between-group analysis. Results Thirty-three (47%) patients, (30% women, 70% men, p < 0.01), were categorized as having hip-related groin pain. The hip-related groin pain group had a higher activity level during adolescence (p = 0.013), and a higher pre-injury activity level (p = 0.034), compared to the non-hip-related groin pain group. No differences (mean difference (95% CI)) between hip-related groin pain and non-hip-related groin pain were observed for age (0 (− 4; 4)), BMI (− 1.75 (− 3.61; 0.12)), any HAGOS subscales (p ≥ 0.318), any SF-36 subscales (p ≥ 0.142) or pain distribution (p ≥ 0.201). Conclusions Only half of the patients referred to tertiary care for long-standing hip and groin pain, who were predominantly men with a high activity level, had hip-related groin pain. Self-reported pain localization and distribution did not differ between patients with hip-related groin pain and those with non-hip-related groin pain, and both patient groups had poor perceived general health, and hip-related symptoms and function.

Less hip range of motion is associated with a greater alpha angle in people with longstanding hip and groin pain

“…Participants were consecutively recruited from the Department of Orthopaedics at Skåne University Hospital, Sweden, between 2014 and 2017 as previously described [ 35 ] (Fig. 1 ).…”

Femoroacetabular impingement syndrome and labral injuries: grading the evidence on diagnosis and non-operative treatment—a statement paper commissioned by the Danish Society of Sports Physical Therapy (DSSF)

“…95 101 Since the test elicits high acetabular labral strains, 102 and thus is expected to capture intra-articular pathology, no pain during the FADIR test is considered to rule out hip-related pain. Conversely, the test demonstrates poor specificity, 95 representing a high false-positive rate. 96 Therefore, using the FADIR test as an isolated confirmatory test to diagnose FAI syndrome/labral injury or hip-related pain is not recommended.…”

“…Diagnosis of FAI syndrome/labral injuries remains a clinical challenge, 2 94 possibly due to extra-articular causes of groin pain having a similar clinical presentation. 95 The Warwick Agreement defined FAI syndrome to be present based on a combination of symptoms (eg, stiffness, pain, etc), clinical signs (eg, positive impingement test, restricted range of motion, etc), and radiological findings (cam and/or pincer morphology). 1 For clinicians without easy access to imaging modalities, knowing the diagnostic effectiveness of specific symptoms and clinical signs for FAI syndrome/labral injury is useful.…”

Génesis y evolución de la artroplastia de cadera

“…Estudios de corte transversal en Estados Unidos han reportado la prevalencia de coxalgia hasta del 19,2 % en los pacientes adultos mayores de 65 años (1). Otras estimaciones han documentado que hasta el 40 % de los adultos mayores de 64 años en Inglaterra manifiestan dolor articular en cadera o rodilla secundarios a patología inflamatoria (1,2,3); es un síntoma detrás del cual se esconden un amplio espectro de condiciones clínicas, entre estas osteoartrosis de la cadera, secuelas por deformidad congénita, secuelas de osteonecrosis, lesiones traumáticas, infecciones osteoarticulares, entre otros, por lo cual la cirugía ortopédica ha evolucionado a lo largo de los años para proveer a los pacientes mejoría clínica en términos de dolor, movilidad, discapacidad física y calidad de vida (3,4).…”