Abstract
ABSTRACTThe primary aim was to identify muscle-tendon-related pain in 100 patients with hip dysplasia. The secondary aim was to test whether muscle-tendon-related pain is associated with self-reported hip disability and muscle strength in patient with hip dysplasia. One hundred patients (17 men) with a mean age of 29 years (SD 9) were included. Clinical entity approach was carried out to identify muscle-tendon-related pain. Associations between muscle-tendon-related pain and self-reported hip disability and muscle strength were tested with multiple regression analysis, including adjustments for age and gender. Self-reported hip disability was recorded with the Copenhagen Hip and Groin Outcome Score (HAGOS), and muscle strength was assessed with a handheld dynamometer. Iliopsoas- and abductor-related pain were most prevalent with prevalences of 56% (CI 46; 66) and 42% (CI 32; 52), respectively. Adductor-, hamstrings- and rectus abdominis-related pain were less common. There was a significant inverse linear association between muscle-tendon-related pain and self-reported hip disability ranging from −3.35 to − 7.51 HAGOS points in the adjusted analysis (P < 0.05). Besides the association between muscle-tendon-related pain and hip extension a significant inverse linear association between muscle-tendon-related pain and muscle strength was found ranging from −0.11 to − 0.12 Nm/kg in the adjusted analysis (P < 0.05). Muscle-tendon-related pain exists in about half of patients with hip dysplasia with a high prevalence of muscle-tendon-related pain in the iliopsoas and the hip abductors and affects patients' self-reported hip disability and muscle strength negatively.
Highlights
Symptomatic hip dysplasia normally presents in early life [1] and left untreated, hip dysplasia may lead to development of early osteoarthritis [2, 3]
Patients with symptomatic hip dysplasia are characterized by a high prevalence of muscle-tendon-related pain assessed with the clinical entity approach, and muscle-tendon-related pain affects patients’ self-reported hip disability and muscle strength
The findings suggest that muscle strength and hip disability may potentially be improved through exercise therapy focusing on reducing muscle-tendon-related lower extremity pain
Summary
Symptomatic hip dysplasia normally presents in early life [1] and left untreated, hip dysplasia may lead to development of early osteoarthritis [2, 3]. The lack of acetabular support to the femoral head [4] and the compromised passive stability of the hip joint lead to an increased mechanical pressure on the acetabular labrum and cartilage [2], and intra-articular injury has been reported as one important predisposing factor to development of osteoarthritis [2]. Labrum injury or degeneration is present in 49– 83% of patients with hip dysplasia [2, 5], and causes pain at the groin and/or lateral to the hip [5, 6]. The shallow acetabulum and the reduced weight bearing are associated with increased load on the muscles acting close to the hip joint [7, 8], and muscle-tendon-related pain may potentially coexist with intra-articular pathology.
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