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

BMC Musculoskelet Disord. 2019 Sep 14;20(1):432. doi: 10.1186/s12891-019-2794-7.

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.

Keywords: Groin; Hip joint; Pain; Patient reported outcomes; Prevalence.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Arthralgia / complications*
  • Arthralgia / therapy
  • Cross-Sectional Studies
  • Female
  • Femoracetabular Impingement / diagnosis
  • Femoracetabular Impingement / epidemiology*
  • Femoracetabular Impingement / etiology
  • Groin*
  • Hip Joint
  • Humans
  • Male
  • Middle Aged
  • Musculoskeletal Pain / diagnosis
  • Musculoskeletal Pain / epidemiology*
  • Musculoskeletal Pain / etiology
  • Patient Reported Outcome Measures*
  • Physical Examination
  • Prevalence
  • Self Report / statistics & numerical data
  • Tertiary Healthcare / statistics & numerical data
  • Time Factors