Zakikhany Nickan, Lange Jeppe, Lund Bent, Bohn Marie B
H-HiP, Department of Orthopedic Surgery, Horsens Regional Hospital, Strandpromenaden 35, Horsens, 8700, Denmark.
Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Blvd 82, Aarhus N, 8200, Denmark.
BMC Musculoskelet Disord. 2025 Jul 10;26(1):676. doi: 10.1186/s12891-025-08889-1.
Insertional hip abductor tendon pathology (tendinopathy or tears of gluteus medius and/or minimus tendons) are increasingly recognized as the main cause of lateral hip pain. This study aims to evaluate generic health status in patients with lateral hip pain due to Magnetic Resonance Imaging (MRI) verified hip abductor tendon pathology using the EQ-5D-5L and compare these findings with a matched national population norm.
Data from patients with lateral hip pain, referred to our hospital from 2017-2023, was retrospectively reviewed. Females aged 18+ years, with positive clinical tests and MRI verified hip abductor tendon pathology, who had completed the EQ-5D-5L at relevant timepoints, were included. Our treatment algorithm consisted of a baseline physiotherapist led intervention (patient education followed by 3-months un-supervised training). Surgery was offered to patients who, after the intervention, had recalcitrant lateral hip pain and MRI verified tendon tears. Post hoc two treatment groups were identified. The EQ-index scores were calculated from individual health profiles using a national value set. The student's t-test was used to compare groups. Summary statistics are used, including numbers of patients and proportions of categorical responses for the five EQ-5D dimensions. To compare responses between groups, the Fisher's exact test was used.
Ninety-seven female patients were included; 48 (57±12 years) received rehabilitation only (REHAB) and 49 (59±11 years) underwent subsequent surgery (SURG). At baseline, the mean EQ-index was inferior to population norms. After 3 months of rehabilitation, EQ-index (p<0.0001) and EQ-VAS (p=0.004) improved in REHAB, but not in SURG (EQ-index: p=0.32, EQ-VAS: p=0.22). Twelve months after surgery, EQ-index (p<0.0001) and EQ-VAS (p<0.0001) improved and, notably, the dimension "pain/discomfort" was comparable to population norms (p=0.788).
Generic health status in female patients suffering from lateral hip pain due to hip abductor tendon pathology is severely affected compared to a national population norm measured with the EQ-5D-5L. Generic health status may improve after three months of patient education and rehabilitation in some cases, while surgery may improve health status three months postoperative in the remaining cases.
The study is registered at the Central Denmark Region List of Research Projects (Jr nr: 1-16-02-761-17 and 1-16-02-125-19).
髋外展肌肌腱病变（臀中肌和/或臀小肌肌腱病或撕裂）日益被认为是髋部外侧疼痛的主要原因。本研究旨在使用EQ-5D-5L评估经磁共振成像（MRI）证实存在髋外展肌肌腱病变的髋部外侧疼痛患者的一般健康状况，并将这些结果与匹配的全国人群规范进行比较。
回顾性分析2017年至2023年转诊至我院的髋部外侧疼痛患者的数据。纳入年龄在18岁及以上、临床检查阳性且MRI证实存在髋外展肌肌腱病变、在相关时间点完成EQ-5D-5L评估的女性患者。我们的治疗方案包括由物理治疗师主导的基线干预（患者教育，随后进行3个月的无监督训练）。对于干预后仍有顽固性髋部外侧疼痛且MRI证实肌腱撕裂的患者，提供手术治疗。事后确定了两个治疗组。使用国家价值集从个体健康概况计算EQ指数得分。采用学生t检验比较组间差异。使用汇总统计数据，包括患者数量和五个EQ-5D维度的分类反应比例。为比较组间反应，采用Fisher精确检验。
纳入97名女性患者；48名（57±12岁）仅接受康复治疗（REHAB组），49名（59±11岁）随后接受了手术治疗（SURG组）。基线时，平均EQ指数低于人群规范。康复治疗3个月后，REHAB组的EQ指数（p<0.0001）和EQ视觉模拟量表（EQ-VAS，p=0.004）有所改善，但SURG组未改善（EQ指数：p=0.32，EQ-VAS：p=0.22）。手术后12个月，EQ指数（p<0.0001）和EQ-VAS（p<0.0001）有所改善，值得注意的是，“疼痛/不适”维度与人群规范相当（p=0.788）。
与使用EQ-5D-5L测量的全国人群规范相比，因髋外展肌肌腱病变导致髋部外侧疼痛的女性患者的一般健康状况受到严重影响。在某些情况下，患者教育和康复治疗3个月后一般健康状况可能会改善，而在其余情况下，手术可能会在术后3个月改善健康状况。
本研究已在丹麦中部地区研究项目列表中注册（Jr编号：1-16-02-761-17和1-16-02-125-19）。
