Does bony hip morphology affect the outcome of treatment for patients with adductor-related groin pain? Outcome 10 years after baseline assessment
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Does bony hip morphology affect the outcome of treatment for patients with adductor-related groin pain? Outcome 10 years after baseline assessment. / Hölmich, Per; Thorborg, Kristian; Nyvold, Per; Klit, Jakob; Nielsen, Michael B; Troelsen, Anders.
I: British Journal of Sports Medicine, Bind 48, Nr. 16, 08.2014, s. 1240-1244.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Does bony hip morphology affect the outcome of treatment for patients with adductor-related groin pain?
T2 - Outcome 10 years after baseline assessment
AU - Hölmich, Per
AU - Thorborg, Kristian
AU - Nyvold, Per
AU - Klit, Jakob
AU - Nielsen, Michael B
AU - Troelsen, Anders
N1 - Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
PY - 2014/8
Y1 - 2014/8
N2 - BACKGROUND: Adductor-related groin pain and bony morphology such as femoroacetabular impingement (FAI) or hip dysplasia can coexist clinically. A previous randomised controlled trial in which athletes with adductor-related groin pain underwent either passive treatment (PT) or active treatment (AT) showed good results in the AT group. The primary purpose of the present study was to evaluate if radiological signs of FAI or hip dysplasia seem to affect the clinical outcome, initially and at 8-12 years of follow-up.METHODS: 47 patients (80%) were available for follow-up. The clinical result was assessed by a standardised clinical outcome combining patient-reported activity, symptoms and physical examination. Anterioposterior pelvic radiographs were obtained and the centre-edge angle of Wiberg, α angle, presence of a crossover sign and Tönnis grade of osteoarthritis were assessed by a blinded observer using a reliable protocol.RESULTS: No significant between-group differences regarding the distribution of radiological morphologies were found. There was a decrease over time in clinical outcome in the AT group with α angles >55° compared to those with α angles <55° (p=0.047). In the AT group, there was no significant difference in the distribution of Tönnis grades between hips that had an unchanged or improved outcome compared with hips that had a worse outcome over time (p=0.145).CONCLUSIONS: No evidence was found that bony hip morphology related to FAI or dysplasia prevents successful outcome of the exercise treatment programme with results lasting 8-12 years. The entity of adductor-related groin pain in physically active adults can be treated with AT even in the presence of morphological changes to the hip joint.
AB - BACKGROUND: Adductor-related groin pain and bony morphology such as femoroacetabular impingement (FAI) or hip dysplasia can coexist clinically. A previous randomised controlled trial in which athletes with adductor-related groin pain underwent either passive treatment (PT) or active treatment (AT) showed good results in the AT group. The primary purpose of the present study was to evaluate if radiological signs of FAI or hip dysplasia seem to affect the clinical outcome, initially and at 8-12 years of follow-up.METHODS: 47 patients (80%) were available for follow-up. The clinical result was assessed by a standardised clinical outcome combining patient-reported activity, symptoms and physical examination. Anterioposterior pelvic radiographs were obtained and the centre-edge angle of Wiberg, α angle, presence of a crossover sign and Tönnis grade of osteoarthritis were assessed by a blinded observer using a reliable protocol.RESULTS: No significant between-group differences regarding the distribution of radiological morphologies were found. There was a decrease over time in clinical outcome in the AT group with α angles >55° compared to those with α angles <55° (p=0.047). In the AT group, there was no significant difference in the distribution of Tönnis grades between hips that had an unchanged or improved outcome compared with hips that had a worse outcome over time (p=0.145).CONCLUSIONS: No evidence was found that bony hip morphology related to FAI or dysplasia prevents successful outcome of the exercise treatment programme with results lasting 8-12 years. The entity of adductor-related groin pain in physically active adults can be treated with AT even in the presence of morphological changes to the hip joint.
KW - Abdominal Pain
KW - Adult
KW - Exercise Therapy
KW - Femoracetabular Impingement
KW - Follow-Up Studies
KW - Groin
KW - Hip Dislocation
KW - Humans
KW - Middle Aged
KW - Sports Medicine
KW - Treatment Outcome
U2 - 10.1136/bjsports-2013-092478
DO - 10.1136/bjsports-2013-092478
M3 - Journal article
C2 - 23847009
VL - 48
SP - 1240
EP - 1244
JO - British Journal of Sports Medicine
JF - British Journal of Sports Medicine
SN - 0306-3674
IS - 16
ER -
ID: 138498192