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The relationship of femoral neck shaft angle and adiposity to greater trochanteric pain syndrome in women. A case control morphology and anthropometric study
  1. AM Fearon1,2,
  2. S Stephens2,
  3. JL Cook3,
  4. PN Smith1,2,
  5. T Neeman4,
  6. W Cormick5,
  7. JM Scarvell2
  1. 1Department of Medicine, Biology and the Environment, Australian National University, Canberra, Australian Capital Territory, Australia
  2. 2Department of Surgery, The Trauma and Orthopaedic Research Unit, Canberra, Australian Capital Territory, Australia
  3. 3Primary Health Care, Monash University, Melbourne, Victoria, Australia
  4. 4Statistical Consulting Unit, Australian National University, Acton, Australian Capital Territory, Australia
  5. 5Canberra Specialist Ultrasound, Deakin West, Australian Capital Territory, Australia
  1. Correspondence to Fearon AM, Centre for Hip Health and Mobility, 7th Floor, 2635 Laurel St Robert H.N. Ho Research Centre Vancouver, BC, Canada V5Z 1M9 angie.fearon{at}hiphealth.ca

Abstract

Objective To evaluate if pelvic or hip width predisposed women to developing greater trochanteric pain syndrome (GTPS).

Design Prospective case control study.

Participants Four groups were included in the study: those gluteal tendon reconstructions (n=31, GTR), those with conservatively managed GTPS (n=29), those with hip osteoarthritis (n=20, OA) and 22 asymptomatic participants (ASC).

Methods Anterior-posterior pelvic x-rays were evaluated for femoral neck shaft angle; acetabular index, and width at the lateral acetabulum, and the superior and lateral aspects of the greater trochanter. Body mass index, and waist, hip and greater trochanter girth were measured. Data were analysed using a one-way analysis of variance (ANOVA; posthoc Scheffe analysis), then multivariate analysis.

Results The GTR group had a lower femoral neck shaft angle than the other groups (p=0.007). The OR (95% CI) of having a neck shaft angle of less than 134°, relative to the ASC group: GTR=3.33 (1.26 to 8.85); GTPS=1.4 (0.52 to 3.75); OA=0.85 (0.28 to 2.61). The OR of GTR relative to GTPS was 2.4 (1.01 to 5.6). No group difference was found for acetabular or greater trochanter width. Greater trochanter girth produced the only anthropometric group difference (mean (95% CI) in cm) GTR=103.8 (100.3 to 107.3), GTPS=105.9 (100.2 to 111.6), OA=100.3 (97.7 to 103.9), ASC=99.1 (94.7 to 103.5), (ANOVA: p=0.036). Multivariate analysis confirmed adiposity is associated with GTPS.

Conclusion A lower neck shaft angle is a risk factor for, and adiposity is associated with, GTPS in women.

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Footnotes

  • Funding Angela Fearon was supported by an Australian National University scholarship. Funding for imaging was provided from university funding. Jill Cook was the Australian centre for research into sports injury and its prevention, which is one of the International Research Centres for Prevention of Injury and Protection of Athlete Health supported by the International Olympic Committee (IOC).

  • Competing interests None.

  • Ethics approval ACT Health Human Research Ethics Committee; The Australian National University Human Research Ethics Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The data set is held by Dr Angela Fearon (angie.fearon{at}hiphealth.ca).

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