Relationship of self-reported pain, degree of hip dysplasia, and behavioral health diagnosis

Abstract This retrospective analysis investigated relationships between pain levels, the extent of hip dysplasia, and behavioral health diagnoses in adolescent and adult patients diagnosed with developmental dysplasia of the hip (DDH). 105 patients (119 hips, age: 22.5 ± 0.7 yrs, body mass index (BMI): 24.8 ± 0.53) with DDH were included, focusing on demographic information, pain assessments (VAS), lateral center-edge angle (LCEA) measurements, and behavioral health data. Patients were white (92%), female (90%), and privately insured (77%). The average VAS score was moderate, 4.2 ± 2.7. No significant difference was found in pain or LCEA based on age, although higher pain was correlated with milder dysplasia (r = .254). Patients reporting severe pain had the most mild degree of dysplasia (LCEA 18.1° ± 4.9°). When analyzing those who underwent surgery, 18 patients (20/96 surgical hips) had mild pain, with an average LCEA of 13.7° ± 8.4 and 20 patients (21/96 surgical hips) had severe pain with an average LCEA of 17.8° ± 5.2°. In the nonsurgical group (n = 24 hips), 38% reported moderate/severe pain with mild hip dysplasia (LCEA = 17.6° ± 4.0). 74 patients received MRI imaging; labral tears were identified in 53 hips. Higher pain scores were associated with a labral tear (P < .05). 30% (n = 32) of patients had at least one behavioral health (BH) diagnosis. A trend was observed for longer duration of symptoms in patients with BH diagnosis: 26.5 ± 26.9 months versus 19.2 ± 16.0 months, P = .090. This study emphasizes the intricate relationships between anatomical, psychological, and socio-demographic factors in the perception of pain related to DDH, highlighting the necessity for multidisciplinary strategies in treatment planning and surgical decision making.