Epidemiology of Generalized Ligamentous Laxity in Iran: A National Study Including Different Iranian Ethnic Groups and its Relationship with Musculoskeletal Disorders

Hossein Saremi; Mohammad H Ebrahimzadeh; Sepehr Shiruei; Manoochehr Karami; Alireza Rouhani; Omid Reza Momenzadeh; Mohsen Mardani-Kivi; Hanon Sadoni; Farnaz Shahbazi; Mohammad Dehghani; Ali Karbalaeikhani

doi:10.22038/ABJS.2022.56641.2813

Epidemiology of Generalized Ligamentous Laxity in Iran: A National Study Including Different Iranian Ethnic Groups and its Relationship with Musculoskeletal Disorders

Arch Bone Jt Surg. 2022 Mar;10(3):286-292. doi: 10.22038/ABJS.2022.56641.2813.

Affiliations

¹ Department of Orthopedics, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.
² Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
³ Research Center for Health sciences, Hamadan University of Medical Sciences, Hamadan, Iran.
⁴ Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
⁵ Bone and Joint Diseases Research Center, Department of Orthopedics, Shiraz University of Medical Sciences, Shiraz, Iran.
⁶ Orthopedic Research Center, Department of Orthopedics, Poursina Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
⁷ Department of Orthopedic Surgery, Faculty of Medicine, Jundishapur University of Medical Sciences, Ahvaz, Iran.
⁸ Students Research Center, Hamadan University of Medical Sciences, Hamadan, Iran.
⁹ Orthopedic Department, Kashani hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
¹⁰ Department of Hand and Microsurgery, Emam Reza Hospital, AJA University of Medical Sciences, Tehran, Iran.

Abstract

Background: Ligamentous laxity is a condition that leads to joints' hypermobility beyond their average and normal range of motion. It can cause musculoskeletal and joint injuries. This national multi-centered study investigated the epidemiology of generalized ligamentous laxity and its relationship with musculoskeletal disorders among Iranian adults with different ethnic backgrounds.

Methods: A total of 1,488 people (age range: 17-40 years) were selected from eight cities and six different ethnicities of Iran and included in this cross-sectional study. The presence of ligamentous laxity with clinical examinations was searched according to Beighton score criteria. They were also examined for any kind of musculoskeletal disorders that might accompany ligamentous laxity. The Chi-square test was used to compare the frequency of ligamentous laxity based on gender and ethnicity; moreover, the t-test was utilized to compare the frequency of ligamentous laxity based on age.

Results: In total, 280 (18.8%) participants had generalized ligamentous laxity, and it was more prevalent in women (22.7%), compared to men (14.4%). Regarding ethnicity, the highest and lowest prevalence rates were in Gilak (37.9%) and Persian-Arab (6%) ethnicities, respectively (P<0.001). Ligamentous laxity showed a significant relationship with sports injury, joint complaint, joint dislocation, ligament sprain, sciatica and back pain, Baker's cyst, and varicose veins (P<0.001). Most participants with generalized ligamentous laxity (93.6%) had no knowledge of their problem and its importance in choosing an appropriate sports activity.

Conclusion: The prevalence of generalized ligamentous laxity seems to be relatively high among the 17-40-year-old population of Iran, especially in women. It seems to be significantly related to ethnicity. It is strongly recommended that examinations, screening, and information be provided at an early age in schools or at least in areas with a high prevalence as national programs.

Keywords: Ethnicity; Hypermobility; Iran; Joint laxity; Ligamentous laxity.