Article Text

Download PDFPDF

What is the prevalence of imaging-defined intra-articular hip pathologies in people with and without pain? A systematic review and meta-analysis
  1. Joshua J Heerey1,
  2. Joanne L Kemp1,
  3. Andrea B Mosler2,
  4. Denise M Jones1,
  5. Tania Pizzari1,
  6. Richard B Souza3,
  7. Kay M Crossley1
  1. 1 La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria, Australia
  2. 2 Rehabilitation Department, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
  3. 3 Department of Physical Therapy and Rehabilitation Science, University of California, San Francisco, California, USA
  1. Correspondence to Joshua J Heerey, La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, College of Science, Health and Engineering, La Trobe University, Melbourne, VIC, Australia; j.heerey{at}latrobe.edu.au

Abstract

Background Intra-articular hip pathologies are thought to be associated with the development of hip and groin pain. A better understanding of the relationship between symptoms and imaging findings may improve the management of individuals with intra-articular hip pathologies.

Objective To undertake a systematic review and meta-analysis to determine the prevalence of intra-articular hip pathologies in individuals with and without pain.

Methods Seven electronic databases were searched in February 2017 for studies investigating the prevalence of intra-articular hip pathologies using MRI, MRA or CT. Two independent reviewers conducted the search, study selection, quality appraisal and data extraction. Meta-analysis was performed when studies were deemed homogenous, with a strength of evidence assigned to pooled results.

Results In general, studies were moderate to high risk of bias, with only five studies adjudged to be low risk of bias. The 29 studies reporting on the prevalence of intra-articular hip pathologies identified limited evidence of a labral tear prevalence of 62% (95% CI 47% to 75%) in symptomatic individuals, with moderate evidence identifying a labral tear prevalence of 54% (95% CI 41% to 66%) in asymptomatic individuals. Limited evidence demonstrated a cartilage defect prevalence of 64% (95% CI 25% to 91%) in symptomatic individuals, compared with moderate evidence of a cartilage defect prevalence of 12% (95% CI 7% to 21%) in asymptomatic individuals.

Conclusion The prevalence of intra-articular hip pathologies is highly variable in both symptomatic and asymptomatic populations. The prevalence of intra-articular hip pathologies appears to be higher in symptomatic individuals. However, imaging-defined intra-articular hip pathologies are also frequently seen in asymptomatic individuals, highlighting a potential discordant relationship between imaging pathology and pain.

PROSPERO registration number CRD42016035444.

  • hip
  • groin
  • cartilage
  • MRI
View Full Text

Statistics from Altmetric.com

Footnotes

  • Contributors JJH, JLK and KMC were responsible for the creation and planning of the review. JJH and JLK were responsible for the search strategy used. JJH, JLK and DMJ developed the strategy to evaluate study quality. JJH, ABM and KMC were involved in the data extraction process. JJH wrote the final manuscript with all authors assisting in revising content.

  • Competing interests None declared.

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

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.