Generalized joint hypermobility in siblings with anterior cruciate ligament injuries and matched unrelated healthy siblings

Keays, Susan L.; Newcombe, Peter; Keays, Anthony C.

doi:10.1002/pri.1826

Cited by 3 publications

(4 citation statements)

References 48 publications

(96 reference statements)

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“…22 In addition, pelvic girdle pain intensity was associated to an extracellular matrix degradation enzyme, 23 supporting the hypothesis that pelvic girdle pain is related to changes in the extracellular components in pelvic ligaments. Furthermore, isolated and generalized joint hypermobility may occur as a familial form 24 and could therefore be a predisposing condition for pregnancy-related pelvic girdle pain. Moreover, shared environmental factors may have contributed to our results, in line with the multifactorial etiology for the disease.…”

Section: Discussionmentioning

confidence: 99%

Heredity of pregnancy‐related pelvic girdle pain in Sweden

Kristiansson

Zöller

Dahl

et al. 2023

Acta Obstet Gynecol Scand

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IntroductionPelvic girdle pain during and after pregnancy is a major public health problem with significant daily problems for affected women and their families. There is now accumulating evidence that pregnancy‐related pelvic girdle pain originates from the sacroiliac joints and the pubic symphysis as well as their extra‐articular ligaments. However, the heritability of the disease remains to be determined. We hypothesized that there is an increased familial risk of pregnancy‐related pelvic girdle pain.Material and methodsA population‐based national database linkage registry study of approximately 9.3 million individuals within 4.2 million families in Sweden with a recruitment period from 1997 to 2018. The Swedish Multi‐generation register was used to find female pairs of twins, full siblings, half‐siblings and first cousins where both in the pairs had a completed pregnancy. The outcome measure was diagnosis of pregnancy‐related pelvic girdle pain (International Classification of Diseases‐10 O26.7 [1997–2018]) in the first pregnancy. Data was obtained from the Swedish Hospital Discharge Register, the Swedish Outpatient Care Register, the Swedish Medical Birth Register, the Primary Healthcare Register, and Medical Treatment Register. Cox regression analysis was used to calculate adjusted estimated effect of the exposure variable familial history of pregnancy‐related pelvic girdle pain on the outcome variable pregnancy‐related pelvic girdle pain at first birth.ResultsFrom the registers, 1 010 064 women pregnant with their first child within 795 654 families were collected. In total, 109 147 women were diagnosed with pregnancy‐related pelvic girdle pain. The adjusted hazard ratio for a familial risk of pregnancy‐related pelvic girdle pain was 2.09 (95% CI 1.85–2.37) among twins (monozygotic and dizygotic), 1.78 (95% CI 1.74–1.82) in full siblings, 1.16 (95% CI 1.06–1.28) in half‐siblings from the mother, 1.09 (95% CI 1.024–1.16) in half‐siblings from the father and 1.09 (95% CI 1.07–1.12) in first cousins.ConclusionsThis nationwide observational study showed a familial clustering of pregnancy‐related pelvic girdle pain. The hazard ratio for the condition was associated with the degree of relatedness, suggesting that heredity factors contribute to the development of pregnancy‐related pelvic girdle pain. There is no causal treatment available for pregnancy‐related pelvic girdle pain and further studies are now encouraged to clarify the specific genetic factors that contribute to the disease and for future targeted interventions.

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Section: Discussionmentioning

confidence: 99%

Heredity of pregnancy‐related pelvic girdle pain in Sweden

Kristiansson

Zöller

Dahl

et al. 2023

Acta Obstet Gynecol Scand

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“…It is suggested to perform the assessment in a standing position as a real determinant of the axis of the lower limbs [21]. In the study of Keays et al [44] a positive correlation between GJH and knee valgus was found. Moreover, it was found that GJH and axis disorders of lower limbs were significantly more common in families with injuries within the knee joints than in non-injured people.…”

Section: Axis Of Lower Limbsmentioning

confidence: 99%

“…Moreover, it was found that GJH and axis disorders of lower limbs were significantly more common in families with injuries within the knee joints than in non-injured people. Screening for both features may help identify and prevent injury [44].…”

Section: Axis Of Lower Limbsmentioning

confidence: 99%

Assessment of lower limbs in people with Generalized Joint Hypermobility (GJH) - preliminary report

Ewertowska¹,

Kleniewska²,

Wasilewski³

et al. 2021

areh

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Introduction: Generalized Joint Hypermobility (GJH) is defined as an increased range of motion in joints. There is no causal treatment of GJH, therefore the therapy should be based on the individual needs of patients after the comprehensive diagnostic of body posture. The occurrence of deformities of lower limbs in people with GJH should be an indication for the therapy. The aim of this study was the assessment of the impact of Generalized Joint Hypermobility on the lower limbs position. Materials and methods: The research was conducted on 30 children, aged 7-13 (10.1±1.7), 51 adults aged 20-29 (23.2±1.6). The study included the assessment of external and internal rotation of hips, tibial torsion, axis of lower limbs, longitudinal and transverse arch of the feet. Females with ≥5 and males with ≥4 scores in the Beighton test were included in the GJH groups. Results: Both children and adults with GJH presents higher internal rotation of hips in comparison to the control group (p=0.03 for right and p=0.00 for left side, and p=0.00 for right and p=0.00 for left side, for children and adults, respectively). Children with GJH obtained higher values of the Clarke angle for the right foot compared to the control group (p=0.00). Conclusions: Regardless of age, subjects with Generalized Joint Hypermobility are characterized by higher internal rotation of the hip compared to healthy controls. Children with GJH present a higher longitudinal arch of the feet compared to peers, but the results fall within the normative ranges.

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“…Generalized joint hypermobility (GJH) has been associated with an increased risk of anterior cruciate ligament (ACL) injury [ 12 , 22 , 23 , 26 ]. Postoperative clinical outcomes in patients with an ACL injury with hypermobility have also been assessed [ 23 ].…”

Section: Introductionmentioning

confidence: 99%

Generalized joint hypermobility does not influence 1-year patient satisfaction or functional outcome after ACL reconstruction

Sundemo

Jacobsson

Karlsson

et al. 2022

Knee Surg Sports Traumatol Arthrosc

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Purpose The purpose of this study was to evaluate whether generalized joint hypermobility (GJH) influences postoperative results, including return to sport, patientreported outcomes, functional performance (hop tests), muscular strength, and the occurrence of ACL re-injury, in patients 1 year after anterior cruciate ligament (ACL) reconstruction. Methods Data was extracted from a regional rehabilitation-specific registry containing information on patients with ACL injury. Patients between the ages of 16–50 years previously undergoing ACL reconstruction with available 1 year follow-up data were eligible for inclusion. Generalized joint hypermobility was assessed using the Beighton score (BS). Patients were examined one year postoperatively in terms of return to sport, patient-reported outcome, hop tests, muscular strength and the occurrence of reinjury. For purpose of analysis, patients were allocated into two groups, depending on the existence of GJH. The KOOS subscale of sports and recreation was considered the primary outcome. Analyses were performed both dichotomously and by using adjusted logistic regression, to consider potential confounders. Results A total of 356 patients (41% males) were included, of which 76 (24% male) were categorized as having GJH. Patients with GJH had an inferior limb symmetry index preoperatively in terms of knee extension (mean 81.6 [SD 16.4] vs. 91.4 [SD 15.9], p = 0.02) and flexion strength (mean 91.9 vs. 99.1, p = 0.047) compared to patients without GJH. There was no difference between the groups in terms of the primary outcome, nor in any of the other postoperative outcomes. Nine patients (11.8%) in the group with GJH suffered ACL re-injury, compared with 13 patients (4.6%) in the control group (n.s.). Conclusion One year after ACL reconstruction the existence of GJH did not affect postoperative patient satisfaction, strength or functional outcome. No conclusive statements can be made regarding the influence of GJH on the risk of ACL re-injury in this particular study. Level of evidence Level II.

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Generalized joint hypermobility in siblings with anterior cruciate ligament injuries and matched unrelated healthy siblings

Cited by 3 publications

References 48 publications

Heredity of pregnancy‐related pelvic girdle pain in Sweden

Heredity of pregnancy‐related pelvic girdle pain in Sweden

Assessment of lower limbs in people with Generalized Joint Hypermobility (GJH) - preliminary report

Generalized joint hypermobility does not influence 1-year patient satisfaction or functional outcome after ACL reconstruction

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