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No Association Between Intrauterine Contraceptive Devices and Musculoskeletal Hip Joint Pain

Christopher T Eberlin, BS
UNITED STATES

No Association Between Intrauterine Contraceptive Devices and Musculoskeletal Hip Joint Pain

Nathan Varady, MD, MBA, UNITED STATES Paul F Abraham, BS, UNITED STATES Michael Peter Kucharik, BS, UNITED STATES Christopher T Eberlin, BS, UNITED STATES David Freccero, MD, UNITED STATES Eric L. Smith, MD, UNITED STATES Scott D Martin, MD, UNITED STATES

Department of Orthopaedic Surgery, Massachusetts General Hospital / Harvard Medical School, Boston, MA, UNITED STATES

2021 Congress Abstract Presentation 5 minutes Not yet rated

Anatomic Location

Hip / Groin / Thigh

Anatomic Structure

Cartilage

Diagnosis Method

Physical Examination

Sports Medicine

Epidemiology

Treatment / Technique

Arthroscopy

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Summary: In this study, we found no evidence that IUDs were associated with hip pain or surgery, which was in contrast to our hypothesis.

Introduction

The purpose of this study was to investigate the association between IUD usage and hip pain and surgery. We hypothesized that patients with IUDs would have higher rates of hip pain and surgery compared to patients with contraceptive implants.

Methods

This was a retrospective cohort study of patients 18-44 years old using either IUDs or subdermal implants for contraception in a large commercial claims database (MarketScan) from 2012-2015. Contraceptive implants were chosen as the active comparator to IUDs given that they are another form of highly-effective, long-acting contraception that require a procedure to initiate. However, they are not local to the pelvic region (typically implanted in the arm), and therefore have no clear mechanism of causing hip pain. All patients had to =12 months of continuous enrollment both before and after contraceptive placement; patients with a history of hip pain or surgery were excluded. Baseline factors including age, region, year of insertion, and contraceptive history were collected. The primary outcome was new hip pain. Secondary outcomes included visiting an orthopaedic or sports medicine provider for a hip complaint, intraarticular hip injection, and arthroscopic hip surgery. Outcomes were analyzed with adjusted Cox-proportional hazard models. The date of contraceptive placement was considered the index date, and patients were then followed until the occurrence of each respective outcome, censoring on database drop out. Sensitivity analyses included additional censoring for contraceptive removal for non-musculoskeletal reasons, as well as comparing copper and hormonal IUDs.

Results

We identified a total of 291,012 patients, 253,772 (87.2%) with IUDs and 37,240 (12.8%) with subdermal contraceptive implants. Implant patients were younger and more likely to live in the South and North Central United States, while IUD patients were common in the West. Additionally, implant became more common with time. Overall, 6108 (2.1%) patients experienced new hip pain in the follow-up period, 891 (0.3%) saw an orthopaedic surgeon or sports medicine specialist for that pain, 317 (0.1%) underwent intraarticular hip injection, and 91 (0.0%) underwent hip arthroscopy. In time-to-event analysis, IUDs (vs. implants) were not associated with increased risk of new hip pain diagnoses (hazard ratio [HR] 0.98, 95% CI 0.89-1.08, p=0.71). In contrast, both increasing age (p<0.001) and year (p=0.006) were associated with increased risk of new hip pain. Similar results were seen for the secondary outcomes, including risk of orthopaedic visits for hip complaints (HR 1.04, 95% CI 0.8-1.36, p=0.75), intraarticular injections of the hip (HR 1.03, 95% CI 0.64-1.66, p=0.89), and hip arthroscopy procedures (HR 1.13, 95% CI 0.54-2.35, p=0.74). Results held in all sensitivity analyses.

Discussion And Conclusion

Identifying and ruling out non-musculoskeletal causes of patients’ symptoms is critical to avoiding unnecessary orthopaedic surgery. While there are many gynecologic pathologies that can occasionally present with symptoms consistent with musculoskeletal hip pain, whether contraceptive IUDs are associated with this clinical presentation was unknown. In this study, we found no evidence that IUDs were associated with hip pain or surgery, which was in contrast to our hypothesis.

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Health Literacy in Hip Arthroscopy: A Quantitative Assessment of the Understandability and Readability of Online Patient Education ePoster Presentation Alan Shamrock, MD, UNITED STATES Burke Gao, MD, UNITED STATES Olivia O'Reilly, MD, UNITED STATES Mary Kate Skalitzky, BA, UNITED STATES Trevor Gulbrandsen, MD, UNITED STATES Michael C. Willey, MD, UNITED STATES Robert W. Westermann, MD, UNITED STATES
Cannabis Use Is Not Associated With Increased Opioid Use Or Costs After Hip Arthroscopy Abstract Presentation 5 minutes Christopher L. McCrum, MD, UNITED STATES Jacob Thomas Wood, BS, UNITED STATES Senthil Sambandam, MD, UNITED STATES
Arthroscopic Tendon Release for Iliopsoas Impingement after Total Hip Arthroplasty ePoster Presentation Michael Andreas Finsterwald, MD, AUSTRALIA Georgina Waters, MD, AUSTRALIA Jay R. Ebert, PhD, AUSTRALIA Christopher W. Jones, FAOrthA FRACS PhD MBBS(Hons) BEng(Hons) BCom, AUSTRALIA Piers Yates, MBBS(Hons) BSc(Hons) MRCS(Eng) FRCS(Tr & Orth) FRA, AUSTRALIA Peter Alberto D'Alessandro, MBBS Hons. (UWA) FRACS FAOrthA, AUSTRALIA
Capsular Complications And Subsequent Instability On The Rise As Indications For Revision Hip Arthroscopy ePoster Presentation Ryan S. Selley, MD, UNITED STATES Molly A Day, MD, UNITED STATES Reena Olsen, BS, UNITED STATES Cort D. Lawton, MD, UNITED STATES Matthew S. Dooley, MA, UNITED STATES Stephanie S Buza, MD, UNITED STATES Bryan T. Kelly, MD, UNITED STATES Anil S. Ranawat, MD, UNITED STATES Danyal H. Nawabi, MD, FRCS(Orth), UNITED STATES
Labral Size Correlates With Increasing Intraarticular Damage At Time Of Arthroscopy In Borderline Dysplastic Patients ePoster Presentation Jacob Shapira, MD, UNITED STATES Jeffrey Chen, BA, UNITED STATES Mitchell Yelton, BS, UNITED STATES Philip Joseph Rosinsky, MD, UNITED STATES David R. Maldonado, MD, UNITED STATES Mitchell Meghpara, MD, UNITED STATES Ajay C. Lall, MD, MS, FAAOS, UNITED STATES Benjamin G. Domb, MD, UNITED STATES
Comparison Of Pull-Out Strength Following Ligamentum Teres Reconstruction In The Hip: Peek Corkscrew Suture Anchor Versus Cortical Button Fixation: A Cadaveric Study. Abstract Presentation 5 minutes Ajay C. Lall, MD, MS, FAAOS, UNITED STATES Hari Krishna Ankem, MD, UNITED STATES Samantha Diulus, BS, UNITED STATES Benjamin G. Domb, MD, UNITED STATES
Treatment Modalities And Outcomes Following Acetabular Fractures In The Elderly: A Systematic Review Abstract Presentation 3 minutes Brian McCormick, MD, UNITED STATES Joseph Serino, MD, UNITED STATES Sebastian Orman, MD, UNITED STATES Alex R. Webb, MD, UNITED STATES David X. Wang, MD, UNITED STATES Sharri Mortenson, MD, UNITED STATES Arvind Von Keudell, MD, UNITED STATES
Can BMAC Application Safely Diminish Perioperative Pain In Patients Undergoing Hip Arthroscopy? Abstract Presentation 5 minutes Michael Peter Kucharik, BS, UNITED STATES Paul F Abraham, BS, UNITED STATES Mark R. Nazal, MPH, UNITED STATES Nathan Varady, MD, MBA, UNITED STATES Wendy Madeline Meek, BBA, UNITED STATES Stephen M Gillinov, AB, UNITED STATES Christopher T Eberlin, BS, UNITED STATES Scott D Martin, MD, UNITED STATES
Outcomes of Proximal Hamstring Tendon Repair in Patients Older than 50 Years of Age Abstract Presentation 5 minutes Alexander Rainer Manuel Bitzer, MD, UNITED STATES Daniel Hurwit, UNITED STATES Julian Joseph Sonnenfeld, MD, UNITED STATES Durham Weeks, MD, UNITED STATES
Outcomes of Associated Both Column Acetabular Fractures with and without a Posterior Wall Fracture ePoster Presentation George Bradley Reahl, MS, UNITED STATES Michael McTague, MPH, UNITED STATES Nishant Suneja, MD, UNITED STATES Arvind Von Keudell, MD, UNITED STATES
Female Athletes Demonstrate Greater Improvement in Patient Reported Outcome Scores and Equal Return To Sport Rates Compared to Males After Hip Arthroscopy A Gender Based Matched Comparison of High-Level Athletes Abstract Presentation 4 minutes Andrew Jimenez, MD, UNITED STATES Rachel Glein, BS, UNITED STATES Kara Miecznikowski, BS, UNITED STATES Benjamin Saks, MD, UNITED STATES Hari Krishna Ankem, MD, UNITED STATES Payam William Sabetian, MD, GUATEMALA Benjamin G. Domb, MD, UNITED STATES
The Surgeon Mentor Program: Outcomes of Total Hip Arthroplasty via the Direct Anterior Approach ePoster Presentation Christopher J. Wilson, A/Prof, MBChB, MRCS, FRACS, PhD, AUSTRALIA Melinda Jiang, MD, AUSTRALIA Mark Inglis, FRACS BMBS B Med Sci FOrthoA, AUSTRALIA David Morris, MD, AUSTRALIA Nathan Eardley-Harris , MBBS, MClinSc, AUSTRALIA
A Comparison Of Perioperative Outcomes Between Patients Who Underwent Hip Arthroscopy With And Without The Pericapsular Nerve Group Block ePoster Presentation Albert A Yusupov, MD, UNITED STATES Iciar M Davila Castrodad, MD, UNITED STATES Matthew J. Kraeutler, MD, UNITED STATES Christopher J Mazzei, MD, UNITED STATES Stephen A. Hunt, MD Kimberly V Tucker, MD, UNITED STATES Anthony Scillia, UNITED STATES Patrick A Armstrong, MD, UNITED STATES Mathew S Chow, MD, UNITED STATES Richard A Stennett, MD, UNITED STATES James C Wittig, MD
Hip Osteochondroplasty May Benefit The Non-Ideal Patient With Femoroacetabular Impingement: Analysis From The Embedded Prospective Cohort Of The First Trial Abstract Presentation 6 minutes Mahmoud Almasri, MD, FRCSC, UNITED STATES Nicole Simunovic, MSc, CANADA Diane Heels-Ansdell, MSc, CANADA Olufemi R. Ayeni, MD, PhD, MSc, FRCSC, CANADA FIRST Investigators, MD, CANADA
The Radiographical Influence Of Torsional Deformity Of The Acetabular And Femur In Dysplastic Hips ePoster Presentation Carsten Heimer, BA, GERMANY Carsten Perka, MD, PhD, GERMANY Henrik Baecker, MD, GERMANY
Not Every Hip Impingement Requires Hip Arthroscopy. Abstract Presentation 5 minutes Vitali Goriainov, FRCS (Orth), BM, PhD, MSc, UNITED KINGDOM Mohamed Zubair Farook, MBBS, D.Ortho, FRCS (Orth), UNITED KINGDOM Rajiv Kaila, MRCS, MSc, MFSEM(UK), FEBOT, UNITED KINGDOM Tom CB Pollard, MD, FRCS (Tr & Orth), UNITED KINGDOM Antonio J. M. D. Andrade, MB BS, M.Sc., FRCS(Tr&Orth), UNITED KINGDOM
Superior Outcomes With Routine Capsular Repair In Hip Arthroscopy Abstract Presentation 5 minutes Austin M Looney, MD, UNITED STATES Spencer M Comfort, BS, UNITED STATES Patrick T Connolly, BS, UNITED STATES Julia E McCann, MD, UNITED STATES Andrew Curley, MD, UNITED STATES William F. Postma, MD, UNITED STATES
Endoscopic Iliotibial Band Release During Hip Arthroscopy For Femoroacetabular Impingement Syndrome And External Snapping Hip Had Better Patient-Reported Outcomes: A Retrospective Comparative Study Abstract Presentation 5 minutes 春宝李, 医学博士，博士, CHINA Shanxing Zhang, MD, CHINA
Efficacy Of Tranexamic Acid In Hip Fracture Surgeries ePoster Presentation Aabid Sanaullah, MBBS,MRCS,MRCPS,PGDipTrauma Surg.FEBOT,FRCSTr&Orth, UNITED KINGDOM Adeel Nawab Ditta, MBBS, MRCS, UNITED KINGDOM Olufunso Damilare Onayemi, MRCS MCH (Ortho), UNITED KINGDOM Ahsan Sheeraz, BSc MBBS MRCS, UNITED KINGDOM Atif A. Malik, MB ChB, MRCS Ed, MSc. (Orto. Eng), FRCS Tr & Orth, UNITED KINGDOM

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No Association Between Intrauterine Contraceptive Devices and Musculoskeletal Hip Joint Pain

No Association Between Intrauterine Contraceptive Devices and Musculoskeletal Hip Joint Pain

Introduction

Methods

Results

Discussion And Conclusion

More 2021 Congress Hip Abstract Presentations

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No Association Between Intrauterine Contraceptive Devices and Musculoskeletal Hip Joint Pain

No Association Between Intrauterine Contraceptive Devices and Musculoskeletal Hip Joint Pain

Introduction

Methods

Results

Discussion And Conclusion

More ISAKOS 2021: Global Content