Materiały źródłowe

• #1 Chronic hip pain in adults: Current knowledge and future prospective

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8022067/

  Chronic hip pain is distressing to the patient as it not only impairs the daily activities of life but also affects the quality of life. Chronic hip pain is difficult to diagnose as patients often present with associated chronic lumbar spine and/or knee joint pain. The prevalence of hip pain in the general population is 10%, and it increases with age. In a published study, 14.3% of adults reported significant hip pain on most days over the previous 6 weeks. Hip pain is associated with impairment of simple movements such as sitting and standing which can precipitate chronic pain resulting in impaired functional outcomes and poorer quality of life. The diagnosis of hip pain can be challenging at times due to referred pain from spine or knee, trauma, tumor, abdomen, hernial sites, joint arthropathies, muscular, and neuropathies. Management of chronic hip pain should be mechanistic-based multimodal therapy targeting the pain pathway. This narrative review will describe relevant anatomy, causes, assessment, investigation, and management of chronic hip pain. The focus will be on current evidence-based management of hip osteoarthritis, greater trochanteric pain syndrome, meralgia paresthetica, and piriformis syndrome. Recently, there is emphasis on the role of ultrasound in interventional pain procedures. The use of fluoroscopic-guided radiofrequency in periarticular branches of hip joint has reported to provide pain relief of up to 36 months. However, the current evidence for use of platelet-rich plasma in chronic hip osteoarthritis pain is inconclusive. Further research is required in the management of chronic hip pain regarding comparison of fluoroscopic- and ultrasound-guided procedures, role of platelet-rich plasma, and radiofrequency procedures with long-term follow-up of patients.

• #2 Evaluation of the Patient with Hip Pain | AAFP

  https://www.aafp.org/pubs/afp/issues/2014/0101/p27.html

  Hip pain is a common and disabling condition that affects patients of all ages. […] In one study, 14.3% of adults 60 years and older reported significant hip pain on most days over the previous six weeks. Hip pain often presents a diagnostic and therapeutic challenge. […] The differential diagnosis of hip pain is broad, including both intra-articular and extra-articular pathology, and varies by age. […] A history and physical examination are essential to accurately diagnose the cause of hip pain. […] Hip pain is a common presentation in primary care and can affect patients of all ages. […] The hip examination should evaluate the hip, back, abdomen, and vascular and neurologic systems. […] Age alone can narrow the differential diagnosis of hip pain. […] In older adults, degenerative osteoarthritis and fractures should be considered first.

• #3 Epidemiology of hip and knee pain and its impact on overall health status in older adults. — Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences

  https://www.ndorms.ox.ac.uk/publications/96300

  OBJECTIVES: To obtain prevalence rates of hip and knee pain in elderly people and compare combinations of symptoms with overall health status. […] The percentage reporting hip pain was 19.2% [95% confidence interval (CI) 17.9-20.6], and 32.6% (95% CI 31.0-34.3) reported knee pain. […] The percentage reporting hip and knee pain was 11.3%, and 40.7% reported hip or knee pain. […] SF-36 scores worsened as the number of symptomatic hip and knee joints increased (P0.001 for physical function, physical role limitation and bodily pain). […] Patterns of hip and knee symptoms are complex in older people. Amongst the symptomatic, most have more than one hip/knee affected. This has implications for treatment and health status measurement.

• #4 Insights into Hip pain using Hip X-ray: Epidemiological study of 8,898,044 Koreans | Scientific Reports

  https://www.nature.com/articles/s41598-024-70259-z

  This study found that 864,792 Koreans (9.7% of the population) are currently experiencing hip pain, and 87,098 Koreans (1.0% of the population) show a high Kellgren-Lawrence grade of hip joint. […] Aging is associated with more hip pain, an increased prevalence of various medical complications, and a reduced lifestyle. […] Propensity score matching for age and sex identifies positive associations between hip pain and characteristics such as weight, BMI, diabetes, heart disease, depressive mood, and osteoporosis.

• #5 Prevalence of Self-Reported Pain, Joint Complaints and Knee or Hip Complaints in Adults Aged ≥ 40 Years: A Cross-Sectional Survey in Herne, Germany | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0060753

  Pain and musculoskeletal complaints are among the most common symptoms in the general population. […] Despite their epidemiological, clinical and health economic importance, prevalence data on pain and musculoskeletal complaints for Germany are scarce. […] The following standardized prevalences were assessed: current pain: 59.7%, pain within the past four weeks: 74.5%, current joint complaints: 49.3%, joint complaints within the past four weeks and twelve month: 62.8% and 67.4%, respectively, knee as the site predominantly affected: 30.9%, knee bilateral: 9.7%, hip: 15.2%, hip bilateral: 3.5%, knee and hip: 5.5%. […] The high site specific prevalences of knee and hip complaints underline the necessity to further investigate characteristics and consequences of pain and symptomatic osteoarthritis of these joints in adults in Germany.

• #6 Prevalence of Self-Reported Pain, Joint Complaints and Knee or Hip Complaints in Adults Aged ≥ 40 Years: A Cross-Sectional Survey in Herne, Germany | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0060753

  For knee and hip we assessed: any knee 35.7%, knee bilateral 11.3%, any hip 19.2%, hip bilateral 4.0%, and knee and hip concomitantly 7.6%. […] The predominance of women and the relationship with increasing age has already been reported frequently for both pain and musculoskeletal complaints. […] Given the importance of lower limb function especially for the elderly, the high site specific prevalences of knee and, to a lesser extent, hip complaints underline the necessity to further investigate characteristics and consequences of pain and symptomatic osteoarthritis of the major lower limb joints in adults in Germany.

• #7 Epidemiology of osteoporosis and fragility fractures | International Osteoporosis Foundation

  https://www.osteoporosis.foundation/facts-statistics/epidemiology-of-osteoporosis-and-fragility-fractures

  Nearly 75% of all hip fractures occur in women. […] Hip fractures are invariably associated with chronic pain, reduced mobility, disability, and an increasing degree of dependence. […] After sustaining a hip fracture 10-20% of formerly community dwelling patients require long term nursing care, with the rate of nursing home admission rising with age. […] The proportion in long term care at 12 months remains close to 10%, with admissions also significantly increasing with age, going from 2% for 50-60 year-olds to 35% for 90 year-olds and above. […] In white women, the lifetime risk of hip fracture is 1 in 6, compared with a 1 in 9 risk of a breast cancer diagnosis. […] Hip fractures cause the most morbidity with reported mortality rates up to 20-24% in the first year after a hip fracture, and greater risk of dying may persist for at least 5 years afterwards. Loss of function and independence among survivors is profound, with 40% unable to walk independently, 60% requiring assistance a year later. Because of these losses, 33% are totally dependent or in a nursing home in the year following a hip fracture. […] Scandinavia has the highest reported incidence of hip fracture worldwide. […] Up to 20% of patients die in the first year following hip fractures, mostly due to pre-existing medical conditions. Less than half those who survive the hip fracture regain their previous level of function.

• #8 The prevalence of hip osteoarthritis: a systematic review and meta-analysis | Arthritis Research & Therapy | Full Text

  https://arthritis-research.biomedcentral.com/articles/10.1186/s13075-023-03033-7

  A total of 31 studies were included in our analysis, involving 326,463 participants. […] The pooled prevalence of HOA diagnosed based on the K-L grade2 criterion was 8.55% (95% CI 4.8513.18) worldwide. […] The prevalence of HOA was lowest in Africa at 1.20% (95% CI: 0.402.38), followed by Asia at 4.26% (95% CI 0.0214.93) and North America at 7.95% (95% CI 1.9817.36), and highest in Europe at 12.59% (95% CI 7.1719.25). […] There was no statistically significant difference in HOA prevalence between men (9.42%, 95% CI:4.8115.34) and women at (7.94%, 95% CI: 3.5713.81). […] The regression model showed a correlation between age and the prevalence of HOA. […] HOA has high prevalence worldwide and increases with age. […] The prevalence varies significantly by region but not by patient sex.

• #9 Epidemiology of Hip and Pelvis Injury | Musculoskeletal Key

  https://musculoskeletalkey.com/epidemiology-of-hip-and-pelvis-injury-2/

  Injuries to the hip and pelvis are common among both athletes and the general population. […] The incidence and etiology of hip and pelvis injury vary depending on patients age, gender, anatomy, injury history, and the sport in which they participate. […] Hip and pelvis injury and pain are most common in adolescents and older adults. […] Field-based explosive and contact sports carry the highest risk of hip and pelvis injury. […] Women are twice as likely to suffer from hip pain as men. […] A history of previous injury is the single most important risk factor in injury of the hip and pelvis, followed by age and hip muscle weakness. […] The epidemiologic data regarding incidence of hip and pelvis injury in children have been studied at length, often in association with investigation of injury incidence at other anatomical sites.

• #10 The prevalence of hip osteoarthritis: a systematic review and meta-analysis | Arthritis Research & Therapy | Full Text

  https://arthritis-research.biomedcentral.com/articles/10.1186/s13075-023-03033-7

  High-quality epidemiological studies are warranted to more accurately estimate the prevalence of HOA. […] The findings indicated that HOA was less prevalent in Asia compared to North America and Europe, which was consistent with previous studies. […] In line with previous systematic reviews and individual investigations, a positive association between age and the prevalence of HOA was found. […] This finding confirms that increasing age may be a risk factor for HOA. […] No significant difference in HOA prevalence was found between men and women, which is consistent with previous literature reporting findings on an Indian population and from urography measurements. […] The study established the relationship between age and HOA prevalence. […] The findings point to the need for more high-quality epidemiological studies in the future on the prevalence of HOA, particularly in underrepresented regions such as Africa, Oceania, and South America.

• #11 Epidemiology | International Osteoporosis Foundation

  https://www.osteoporosis.foundation/health-professionals/fragility-fractures/epidemiology

  In 2000, it was estimated that 1.6 million fragility fractures occurred at the hip globally. […] By 2010, the worldwide incidence of hip fractures was estimated to have risen to 2.7 million patients per year. […] Nearly 75% of all hip fractures occur in women. […] Men account for 25% of hip fractures occurring in the over 50 population. […] The peak number of hip fractures occurred at 75-79 years of age for both sexes; for all other fractures, the peak number occurred at 50-59 years and decreased with age. […] Over 55% of patients with hip fracture have evidence of a prior vertebral fracture. […] Hip fracture is associated with serious disability and excess mortality. […] Women who have sustained a hip fracture have a 10-20% higher mortality than would be expected for their age. […] After sustaining a hip fracture 10-20% of formerly community dwelling patients require long term nursing care. […] Hip fracture rates vary markedly between populations. […] Age-standardised annual incidence of hip fractures in women.

• #12 Epidemiology of Hip and Pelvis Injury | Musculoskeletal Key

  https://musculoskeletalkey.com/epidemiology-of-hip-and-pelvis-injury-2/

  Sports injuries to the hip and groin have been noted in 59 % of high school athletes. […] Among adults, the spectrum of hip and pelvis injury evolves. […] The prevalence of hip and pelvis pain in adults from all etiologies ranges from 2.8 % to 22.4 %, and reports of pain tend to increase with age. […] Over the age of 60, fully 14.3 % of adults report significant activity-limiting hip pain. […] Participation in athletic activity of any kind has been shown to increase the risk of hip and pelvis injury, as well as the eventual development of hip osteoarthritis.

• #13 Hip Pain in Adults: Evaluation and Differential Diagnosis | AAFP

  https://www.aafp.org/pubs/afp/issues/2021/0115/p81.html

  Adults commonly present to their family physicians with hip pain, and diagnosing the cause is important for prescribing effective therapy. […] Hip pain is common in adults of all ages and activity levels. In nonelite adult soccer players, hip and groin injuries represent 28% to 45% of all injuries in women and 49% to 55% in men. […] In adults older than 45 years, 6.7% to 9.7% have osteoarthritis of the hip, and one in four adults will develop symptomatic hip osteoarthritis in their lifetime. […] In the United States in 2009, hip replacements accounted for $13.7 billion in health care costs. […] Because femoroacetabular impingement, labral tears, and gluteus medius tendon tears typically have good surgical outcomes, advanced imaging and/or early referral may improve patient outcomes.

• #14 Approach to hip and groin pain in the athlete and active adult – UpToDate

  https://www.uptodate.com/contents/approach-to-hip-and-groin-pain-in-the-athlete-and-active-adult

  Hip and groin injuries occur less frequently than injuries of the knee and ankle in the athletic population but contribute significantly to morbidity among the physically active. […] Approximately 10 percent of those seeking care for injuries in offices of sports medicine clinicians present with hip and/or groin pain, usually of a chronic nature. […] Excluding hip osteoarthritis (OA), as many as 14 percent of adults over 60 years complain of significant hip pain on a weekly basis. […] Hip and groin pain encompass a wide variety of conditions and injuries. In a review of 894 young adult athletes (ages 26 to 30) with chronic groin pain who participated in soccer, rugby, and Gaelic sports, 24 different combinations of clinical injury were identified. Isolated injury to the hip joint was common and occurred in 55.98 percent. Common causes of pain included femoroacetabular impingement (FAI), which was more common in males and accounted for 40 percent of the hip joint problems, labral injury, which was more common in females, accounted for 33 percent, and hip OA accounted for 24 percent.

• #15 Hip Tendonitis and Bursitis: Practice Essentials, Etiology, Epidemiology

  https://emedicine.medscape.com/article/87169-overview

  Hip overuse syndrome is a relatively common condition, particularly in people who are physically active. […] Snapping hip syndrome is the third most common hip pathology in young women and is most frequently observed among gymnasts and ballet dancers. The syndrome has been reported as an incidental finding in approximately 5-10% of the general population. […] Among soccer players, 10-18% of all injuries are hip or groin injuries, and 62% of these are adductor strains. […] An Australian study showed that hamstring injury accounts for 10% of all injuries in field-based team sports (soccer, rugby union, field hockey, Gaelic football, hurling, and Australian football).

• #16 Osteoarthritis of the hip | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/osteoarthritis-of-the-hip?lang=us

  The hip is the third most common joint affected by osteoarthritis after the knee and the hand. Women are more commonly affected than men. Reported prevalence varies in different studies and is also subject to geographic conditions. The lifetime risk of symptomatic hip osteoarthritis in people reaching the age of 85 years was estimated to be as high as 25% in certain regions. […] Attributes, characteristics or exposures that increase the likelihood of developing osteoarthritis of the hip are older age, obesity, genetics, repetitive stress and mechanical overload, farmers, construction workers, high impact sports (football, handball, hockey, wrestling, weight-lifting, and long-distance running), acetabular dysplasia, femoroacetabular impingement, slipped capital femoral epiphysis, Perthes disease, trauma, e.g. hip dislocation or hip fracture.

• #17 The State of Musculoskeletal Health

  https://versusarthritis.org/about-arthritis/data-and-statistics/the-state-of-musculoskeletal-health/

  Estimates are available of the prevalence of many types of arthritis. 10 million people in the UK have Osteoarthritis (OA), an estimated 5.4 million people have knee OA, and an estimated 3.2 million people have hip OA. […] Around a third of the UK population, over 20 million people (20,295,706), live with an MSK condition. 11.6 million women and 8.7 million men, of all ages.

• #18

  https://www.orthobullets.com/recon/5005/hip-osteoarthritis

  Hip Osteoarthritis is degenerative disease of the hip joint that causes progressive loss of articular cartilage of the femoral head and acetabulum. […] Incidence of hip OA (symptomatic) is 88 per 100,000 per year. […] Risk factors for hip osteoarthritis include modifiable factors such as articular trauma, muscle weakness, heavy physical stress at work, and high impact sporting activities, as well as non-modifiable factors like gender, increased age, genetics, and developmental or acquired deformities.

• #19 Hip and Pelvic Arthropathies and Labral Tears | PM&R KnowledgeNow

  https://now.aapmr.org/hip-and-pelvic-arthropathies-and-labral-tears/

  The prevalence of adults with FAI is about 10-15%, with rates increasing consistently between 2000-2016. […] Age-standardized prevalence of symptomatic radiographic hip OA has varied from 1% to 10% in large population-based prevalence surveys. Incidence of symptomatic hip OA is 88 per 100,000 per year. […] Risk factors for hip OA are divided into modifiable and non-modifiable categories. Modifiable risk factors include trauma, body mass index (BMI), muscle weakness, and high impact activities. Non-modifiable risk factors include female gender, increased age, genetics, and developmental or acquired deformities of the lower extremities.

• #20 Hip Pain in Adults: Evaluation and Differential Diagnosis | AAFP

  https://www.aafp.org/pubs/afp/issues/2021/0115/p81.html

  The most common cause of lateral hip pain is greater trochanteric pain syndrome (previously called greater trochanteric bursitis). […] Greater trochanteric pain syndrome presents as lateral hip pain aggravated by ambulation or other physical activities, sitting for long periods, and sleeping on the affected hip. […] The cause of posterior hip pain can be difficult to diagnose. The differential diagnosis includes musculoskeletal causes and referred pain from intrapelvic and gynecologic issues.

• #21 Evaluation of the Patient with Hip Pain | AAFP

  https://www.aafp.org/pubs/afp/issues/2014/0101/p27.html

  Patients with hip pain should be asked about antecedent trauma or inciting activity, factors that increase or decrease the pain, mechanism of injury, and time of onset. […] Acute onset of atraumatic anterior hip pain that results in impaired weight bearing should raise suspicion for transient synovitis and septic arthritis. […] Risk factors for septic arthritis in adults include age older than 80 years, diabetes mellitus, rheumatoid arthritis, recent joint surgery, and hip or knee prostheses. […] MRI is useful for differentiating septic arthritis from transient synovitis. […] Osteoarthritis is the most likely diagnosis in older adults with limited motion and gradual onset of symptoms. […] Patients have a constant, deep, aching pain and stiffness that are worse with prolonged standing and weight bearing. […] Greater trochanteric pain syndrome refers to pain over the greater trochanter. […] Lateral hip pain affects 10% to 25% of the general population.

• #22 Hip Problems: Causes, Symptoms, and Treatments

  https://patient.info/bones-joints-muscles/hip-problems

  Another very common cause of hip pain, it is particularly common in middle-aged women but can also affect younger people, especially runners and footballers. […] A very common fracture in older people that usually happens after a fall. A hip fracture is the most common reason for being admitted as an emergency to a bone (orthopaedic) ward. […] FAI happens because of slight abnormalities in the shape of the 'ball-and-socket’. The movement between the bones can then cause damage to the cartilage on the surfaces and to the other tissues around the edge of the hip joint. It is not known how common FAI is but it is increasingly thought to be a common cause of hip problems, particularly in young adults. […] Septic arthritis is an infection in a joint. It is a rare cause of a hip problem but is serious and needs urgent treatment. It can affect people of any age.

• #23 Epidemiology of osteoporosis and fragility fractures | International Osteoporosis Foundation

  https://www.osteoporosis.foundation/facts-statistics/epidemiology-of-osteoporosis-and-fragility-fractures

  Nearly 75% of hip, spine and distal forearm fractures occur among patients 65 years old or over. […] Although low BMD confers increased risk for fracture, most fractures occur in postmenopausal women and elderly men without a densitometric diagnosis of osteoporosis. […] More than 10 million hip fractures in people aged 55+ occur globally, based on 2019 data. […] With the ageing of the global population, the number of hip fractures is projected to nearly double from 2018 to 2050. […] By 2050, the worldwide incidence of hip fracture is projected to increase by 310% in men and 240% in women, compared to rates in 1990. […] A study of 29 European countries found that the remaining lifetime probability of hip fracture (%) at the age of 50 years was 15.0% (varied by country: 7.0 – 25.1%) in women, and 5.7% (varied by country: 3.8 – 10.9%) in men.

• #24 Improving function in people with hip-related pain: a systematic review and meta-analysis of physiotherapist-led interventions for hip-related pain | British Journal of Sports Medicine

  https://bjsm.bmj.com/content/54/23/1382

  Musculoskeletal conditions, such as hip-related pain, are leading causes of pain and disability in the community, and the second largest global contributor to years lived with disability. Hip and groin injuries are common in active individuals, for example, accounting for up to 18% of professional male football injuries. The true prevalence of non-arthritic hip pain in the general population is unknown, however the burden of hip pain is high, with younger adults with hip-related pain reporting poor patient-reported outcome scores for pain, physical activity and quality of life at a time of life where work and family commitments are large. […] Physiotherapist-led interventions might improve pain and function in young and middle-aged adults with hip-related pain, however full-scale high-quality RCT studies are required.

• #25 Insights into Hip pain using Hip X-ray: Epidemiological study of 8,898,044 Koreans | Scientific Reports

  https://www.nature.com/articles/s41598-024-70259-z

  Hip pain is a prevalent degenerative joint symptoms, imposing a significant global health burden. Hip pain is experiencing an increase in incidences in Korea due to its aging society, and the social burden of hip pain continues to rise as the hip joint is crucial for gait and balance. This study assessed the epidemiology of hip pain in Korea using data from the fifth version of Korea National Health and Nutrition Examination Survey (KNHANES V-5). The research analyzed data from 8,898,044 Koreans to evaluate the prevalence and characteristics of hip pain and abnormal hip X-ray. […] The prevalence of hip pain related diseases, such as OA, is estimated to be over 7% of the global population, with cases increasing by 113.25% from 247.51 million in 1990 to 527.81 million in 2019. […] Prolonged aging in Korea contributes to cumulative hip joint damage, resulting in a 47% increase in annual incidences of primary total hip arthroplasties from 2010 to 2019.

• #26 Hip Surveillance in Cerebral Palsy | AACPDM – American Academy for Cerebral Palsy and Developmental Medicine

  https://www.aacpdm.org/publications/care-pathways/hip-surveillance-in-cerebral-palsy

  Hip displacement and dislocation can lead to pain, reduced function and reduced quality of life. […] Referral to a pediatric physiatrist, developmental paediatrician or pediatric orthopedic surgeon with experience treating hip displacement in children with CP is recommended when there is presence of hip pain on history and/or physical examination. […] The literature supports the completion of hip surveillance in children and youth with cerebral palsy.

• #27 Epidemiology of hip and knee pain and its impact on overall health status in older adults – PubMed

  https://pubmed.ncbi.nlm.nih.gov/14762225/

  Objectives: To obtain prevalence rates of hip and knee pain in elderly people and compare combinations of symptoms with overall health status. […] The percentage reporting hip pain was 19.2% [95% confidence interval (CI) 17.9-20.6], and 32.6% (95% CI 31.0-34.3) reported knee pain. […] Patterns of hip and knee symptoms are complex in older people. Amongst the symptomatic, most have more than one hip/knee affected. This has implications for treatment and health status measurement.

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