Acetabular dysplasia may be related to global joint hyperlaxity

Bilsel, Kerem; Ceylan, Hasan Hüseyin; Yıldız, Fatih; Erden, Tunay; Toprak, Ali; Tuncay, İbrahim

doi:10.1007/s00264-015-3004-3

Cited by 9 publications

(7 citation statements)

References 17 publications

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“…The increased mobility seen in patients with an elevated Beighton score is of importance for the clinician. Generalized joint hypermobility is a risk factor for many musculoskeletal conditions, such as multidirectional shoulder instability, 54 hip instability, 12 femoroacetabular impingement, 46,64 hip dysplasia, 2,7 ACL injury, 60,62 flatfoot, 45 ankle sprains, 16 and many others. Clinicians should have a high index of suspicion for these conditions in this population.…”

Section: Discussionmentioning

confidence: 99%

Interrater and Intrarater Reliability of the Beighton Score: A Systematic Review

Bockhorn

Vera

Dong

et al. 2021

Orthopaedic Journal of Sports Medicine

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Background: The Beighton score is commonly used to assess the degree of hypermobility in patients with hypermobility spectrum disorder. Since proper diagnosis and treatment in this challenging patient population require valid, reliable, and responsive clinical assessments such as the Beighton score, studies must properly evaluate efficacy and effectiveness. Purpose: To succinctly present a systematic review to determine the inter- and intrarater reliability of the Beighton score and the methodological quality of all analyzed studies for use in clinical applications. Study Design: Systematic review; Level of evidence, 3. Methods: A systematic review of the MEDLINE, Embase, CINAHL, and SPORTDiscus databases was performed. Studies that measured inter- or intrarater reliability of the Beighton score in humans with and without hypermobility were included. Non-English, animal, cadaveric, level 5 evidence, and studies utilizing the Beighton score self-assessment version were excluded. Data were extracted to compare scoring methods, population characteristics, and measurements of inter- and intrarater reliability. Risk of bias was assessed with the COSMIN (Consensus-Based Standards for the Selection of Health Measurement Instruments) 2017 checklist. Results: Twenty-four studies were analyzed (1333 patients; mean ± SD age, 28.19 ± 17.34 years [range, 4-71 years]; 640 females, 594 males, 273 unknown sex). Of the 24 studies, 18 reported raters were health care professionals or health care professional students. For interrater reliability, 5 of 8 (62.5%) intraclass correlation coefficients and 12 of 19 (63.2%) kappa values were substantial to almost perfect. Intrarater reliability was reported as excellent in all studies utilizing intraclass correlation coefficients, and 3 of the 7 articles using kappa values reported almost perfect values. Utilizing the COSMIN criteria, we determined that 1 study met “very good” criteria, 7 met “adequate,” 15 met “doubtful,” and 1 met “inadequate” for overall risk of bias in the reliability domain. Conclusion: The Beighton score is a highly reliable clinical tool that shows substantial to excellent inter- and intrarater reliability when used by raters of variable backgrounds and experience levels. While individual components of risk of bias among studies demonstrated large discrepancy, most of the items were adequate to very good.

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Section: Discussionmentioning

confidence: 99%

Interrater and Intrarater Reliability of the Beighton Score: A Systematic Review

Bockhorn

Vera

Dong

et al. 2021

Orthopaedic Journal of Sports Medicine

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“…7,8,17,28,40 In a large cohort study of 721 military personnel, Azma et al 4 demonstrated an increased incidence of ankle sprain and temporomandibular joint dislocation in hypermobile individuals compared with a control group. The authors advocated the usefulness of screening to identify at-risk individuals.…”

Section: Discussionmentioning

confidence: 99%

Generalized Joint Hypermobility Is Predictive of Hip Capsular Thickness

Devitt

Smith

Stapf

et al. 2017

Orthopaedic Journal of Sports Medicine

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Background:The pathomechanics of hip microinstability are not clearly defined but are thought to involve anatomical abnormalities, repetitive forces across the hip, and ligamentous laxity.Purpose/Hypothesis:The purpose of this study was to explore the relationship between generalized joint hypermobility (GJH) and hip capsular thickness. The hypothesis was that GJH would be predictive of a thin hip capsule.Study Design:Cross-sectional study; Level of evidence, 3.Methods:A prospective study was performed on 100 consecutive patients undergoing primary hip arthroscopy for the treatment of hip pain. A Beighton test score (BTS) was obtained prior to each procedure. The maximum score was 9, and a score of ≥4 was defined as hypermobile. Capsular thickness at the level of the anterior portal, corresponding to the location of the iliofemoral ligament, was measured arthroscopically using a calibrated probe. The presence of ligamentum teres (LT) pathology was also recorded.Results:Fifty-five women and 45 men were included in the study. The mean age was 32 years (range, 18-45 years). The median hip capsule thickness was statistically greater in men than women (12.5 and 7.5 mm, respectively). The median BTS for men was 1 compared with 4 for women (P < .001). A statistically significant association was found between BTS and capsular thickness; a BTS of <4 is strongly predictive of having a capsular thickness of ≥10 mm, while a BTS ≥4 correlates with a capsular thickness of <10 mm. There was a statistically greater incidence of LT tears in patients with a capsular thickness of ≤7.5 mm and a BTS of ≥4 (P < .001).Conclusion:Measurement of the GJH is highly predictive of hip capsular thickness. A BTS of <4 correlates significantly with a capsular thickness of ≥10 mm, while a BTS ≥4 correlates significantly with a thickness of <10 mm.

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“…Generalized joint hypermobility is currently recognized as a common, multi-systemic pathology [6]. Hypermobility is a known risk factor for musculoskeletal injuries, including recurrent shoulder dislocation, patellar and ankle instability, anterior cruciate ligament tears and vertebral disc pathology [7–11]. Hip capsular laxity associated with systemic hypermobility may lead to trunk hyperflexion and increasing risk of acetabular labral tear [12, 13].…”

Section: Introductionmentioning

confidence: 99%

Comparable patient-reported outcomes in females with or without joint hypermobility after hip arthroscopy and capsular plication for femoroacetabular impingement syndrome

Stone

Mehta

Beck

et al. 2019

Journal of Hip Preservation Surgery

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Hip arthroscopy is widely utilized to treat femoroacetabular impingement syndrome (FAIS). In order to evaluate the postoperative clinical and functional outcomes at 2-year follow up in patients with and without benign joint hypermobility syndrome following hip arthroscopy with capsular plication for FAIS, consecutive female patients with generalized ligamentous laxity undergoing primary hip arthroscopy with complete T-capsulotomy closure via plication for FAIS were prospectively identified. Patients were matched in a 4:1 ratio based on Beighton-Horan joint mobility index (BHJMI) then classified into no generalized joint laxity (NGJL, Score<4) or generalized joint laxity cohort (GJL, Score=4). Patient and surgical-related factors were analyzed using univariate and paired analysis with statistical significance set at a = 0.05. A total of 125 female patients were included in the study: 25 generalized joint laxity (GJL) patients and 100 matched to age, sex and BMI (NGJL cohort). The results demonstrated that there were no significant differences between demographics, preoperative range of motion, or radiographic analysis on univariate analysis. There was no statistical difference in postoperative range of motion between groups, though both groups demonstrated significant increases in postoperative flexion and postoperative internal rotation following hip arthroscopy. Paired analysis demonstrated no significant difference in HOS-SS, HOS-ADL, mHHS or VAS-pain, while GJL patients reported significantly greater patient satisfaction score at 2-years follow-up (p=0.007). In summary, hip arthroscopy with capsular plication is a highly effective treatment for FAIS in patients with and without generalized joint laxity. In our analysis, patients with and without generalized joint laxity demonstrated statistically similar and significant improvement in outcomes.

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Acetabular dysplasia may be related to global joint hyperlaxity

Cited by 9 publications

References 17 publications

Interrater and Intrarater Reliability of the Beighton Score: A Systematic Review

Interrater and Intrarater Reliability of the Beighton Score: A Systematic Review

Generalized Joint Hypermobility Is Predictive of Hip Capsular Thickness

Comparable patient-reported outcomes in females with or without joint hypermobility after hip arthroscopy and capsular plication for femoroacetabular impingement syndrome

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