Pain sensitivity study in the Dutch population: relationship with current pain, gender and sports

Abstract

without hip-related groin pain. The presence of these features has been used previously as a reason for interventions, with the aim of preventing the development of pain and OA in later life. As such, it is of critical importance to determine whether hip morphology is associated with pain in young active individuals. This study aimed to determine the prevalence of bony morphology/early osteoarthritis (OA) features in football players with and without hip-related groin pain and the relationship between the presence of pain and hip morphology. Methods: This large prospective cohort study was conducted in Victoria and Queensland, Australia. 187 amateur football players (51% soccer/ 49% Australian rules football (ARF); median age 26yrs; height 179cm; weight 79kg; 20% women) with hip/groin pain (pain for at least 6 months; and positive flexion/adduction/internal rotation (FADIR) test); and 55 age-and activity-matched control football players (54% soccer/ 46% ARF; 26yr; 178cm; 78kg; 25% women) were evaluated for bony morphology and early OA features from radiographs. Bony morphology and hip osteoarthritis were measured using anterior-posterior (AP) and Dunn 45 radiographs. Hip morphology was determined using the alpha angle for cam morphology and the lateral centre edge angle (LCEA) for pincer morphology and hip dysplasia. An alpha angle 60 represented cam morphology; alpha angle 78 represented pathological cam morphology; LCEA 40 represented pincer morphology; and LCEA 20 represented hip dysplasia. Hip OA was determined using OARSI atlas to score the different OA features including the presence of osteophytes and joint space narrowing. Between group differences for patient characteristics, morphology and OA were evaluated with parametric and non-parametric tests. Binomial logistic regression (covariates: sex and body mass index (BMI)) determined the relationship between presence of pain (yes/no), morphology and OA features. Statistical significant was set at <0.05. Results: There were no significant differences in patient characteristics between football players with and without hip/groin pain (p¼0.291 to 0.945). The alpha-angle (AP 50 vs 48 p¼0.72; Dunn 68 vs 66 p¼0.274) and LCEA (31 vs 32 p¼0.508) were not different between groups. The prevalence of morphology and OA features did not differ between groups. For the alpha-angle 60 , the prevalence was 69% in the symptomatic group, and 60% in the asymptomatic group (p¼0.223). For the alpha-angle 78 , the prevalence was 38% in the symptomatic group, and 36% in the asymptomatic group (p¼0.85). For the LCEA 40 the prevalence was 7% in the symptomatic group and 7% in the asymptomatic group (p¼1.00). For the LCEA 20 , the prevalence was 4% in the symptomatic group and 3% in the asymptomatic group. The prevalence of osteophytes was 7% in the symptomatic group compared to 5% in the asymptomatic group (p¼0.736). Joint space narrowing was present in 9% of the symptomatic group compared to 5% of the asymptomatic group (p¼0.527). There was no relationship between hip morphology a...