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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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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
Are Image-Guided Intraarticular Hip Injections Associated with an Increased Risk of Infection Following Hip Arthroscopy? Abstract Presentation 5 minutes Nathan Varady, MD, MBA, UNITED STATES Troy Amen, BA, UNITED STATES Ahab Chopra, BA, 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
Treatment of Bilateral Hip Femoroacetabular Impingement: Simultaneous or Staged? Abstract Presentation 5 minutes Gen Lin Foo, MD, SINGAPORE Catherine J. Bacon, PhD, MSc, BSc, BPhed(Hons), NEW ZEALAND Matthew J. Brick, MBChB, FRACS, NEW ZEALAND
Efficacy Of Enoxaparin As A Thromboprophylactic Agent In Major Lower Limb Orthopedic Surgeries. ePoster Presentation Raghavendra Raju, MBBS,MS, INDIA Prasad Soraganvi, MBBS, MS, DNB, MRCS, SICOT-dip, INDIA
A Prospective Comparison Of Groin-Related Complications Following Hip Arthroscopy With Versus Without A Perineal Post ePoster Presentation Iciar M Davila Castrodad, MD, UNITED STATES Matthew J. Kraeutler, MD, UNITED STATES Omer Mei-Dan, MD, UNITED STATES Anthony Scillia, UNITED STATES
Hip Arthroscopic Portals:A New Approach Through Accessory Portals Established Within 3Cm Around Anterolateral Portal ePoster Presentation Kiran Kumar Shah, MD, NEPAL
Segmental Labral Reconstruction With A Polyurethane Scaffold: Assessment Of Femoro-Acetabular Contact Mechanics Abstract Presentation 5 minutes Bruno Capurro, MD, PhD., SPAIN Marc Tey, MD, PhD., SPAIN Francisco Reina, MD, PhD, SPAIN Anna Carrera, MD, PhD., SPAIN Mauricio Gidi, MD, SPAIN Joan Carles Monllau, MD, PhD, Prof., SPAIN
Hip Labrum Reconstruction With A Polyurethane Scaffold: A Preliminary Report Of 3 Cases ePoster Presentation Bruno Capurro, MD, PhD., SPAIN Marc Tey, MD, PhD., SPAIN Raul Torres, MD, SPAIN Fernando Marques, MD, PhD., SPAIN Alfonso León, MD, PhD., SPAIN Oliver Marín-Peña, MD, SPAIN Joan Carles Monllau, MD, PhD, Prof., SPAIN
Natural History Of Femoroacetabular Impingement: Using Machine Learning To Evaluate Risk Factors For Osteoarthritis In A Large Geographic Population Over The Long-Term Abstract Presentation 5 minutes Ayoosh Pareek, MD, UNITED STATES Sunho Ko, MD, KOREA, NORTH Heath Melugin, MD, UNITED STATES Changwung Jo, MD, KOREA, REPUBLIC OF Ryan R Wilbur, BS, UNITED STATES Bryant M. Song, MS, UNITED STATES Aaron J. Krych, MD, UNITED STATES
Can Hip Microinstability Be Predicted By Hip Range Of Motion Abstract Presentation 5 minutes Marc R. Safran, MD, Prof., UNITED STATES Justin Hopkins, MD, UNITED STATES Katia Elisman, BS, UNITED STATES Andrea Finlay, PhD, UNITED STATES Nicole Segovia Pham, MPH, UNITED STATES
Defining Sex-Based Outcomes Following Hip Arthroscopy In Patients With Borderline Hip Dysplasia. ePoster Presentation Benjamin Saks, MD, UNITED STATES James Fox, BBA, UNITED STATES Jade S Owens, BS, UNITED STATES Andrew Jimenez, MD, UNITED STATES Hari Krishna Ankem, MD, UNITED STATES Payam William Sabetian, MD, GUATEMALA Ajay C. Lall, MD, MS, FAAOS, UNITED STATES Benjamin G. Domb, MD, UNITED STATES
EVALUATION OF HIP ARTHROSCOPY IN ELITE ATHLETES WITHOUT HIP DYSPLASIA . OUR EXPERIENCE. A 15-YEAR STUDY ePoster Presentation George D. Tsikouris, MD, GREECE Nikolaos D. Gravvanis, MD, GREECE Georgia S. Dedousi, MD, GREECE Ioannis K. Antonopoulos, GREECE Fanis P. Papadakis, BSc, MSc(cand.), GREECE Demetrios P. Tsikouris, PT, GREECE Eleftherios Tsikouris, BSc in Physiotherapy, GREECE Theodoros G. Troupis, Prof, GREECE
Similar Joint Space Measurements Are Obtained With Supine And Weightbearing Anteroposterior Pelvis Radiographs: Results Of A Prospective Study Abstract Presentation 5 minutes Blake M. Bodendorfer, MD, UNITED STATES Vishal A. Mehta, DO, UNITED STATES Austin M Looney, MD, UNITED STATES Kenneth Tepper, MD, UNITED STATES
Cleft Sign and Bone Marrow Edema of the Pubic Synthesis are Associated with Sports Activity and Bony Morphology Related to Femoroacetabular Impingement in Symptomatic Patients with Labral Tears: A Cohort Study Abstract Presentation 5 minutes Keisuke Nakayama, MD, PhD, JAPAN Hajime Utsunomiya, MD, PhD, JAPAN Soshi Uchida, MD, PhD, JAPAN
Biomechanical Assessment of the Risk of Hip Injury During A 2,000m Ergometer Row Test Abstract Presentation 5 minutes Jordan Page Ankersen, BS, UNITED STATES Stephanie S Gardner, MD, UNITED STATES Bradley S Lambert, PhD, UNITED STATES Joshua D Harris, MD, UNITED STATES Patrick C. McCulloch, MD, UNITED STATES Michael R Moreno, PhD, UNITED STATES Shari Liberman, MD, UNITED STATES
Outcome Measures After Proximal Hamstring Repair: A Systematic Review ePoster Presentation Tara Reza, MPH, UNITED STATES Andre Gordon Perez-Chaumont, BS, UNITED STATES Andrew J Hinkle, BS, UNITED STATES Symone M Brown, MPH, UNITED STATES Mary K. Mulcahey, MD, UNITED STATES
Snapping Hip Syndrome : An Uncommon Cause of Hip Pain ePoster Presentation Pollyanna Christine Ferreira Frazão, MD, PORTUGAL Rui Cardoso, MD, PORTUGAL Daniela Roque, MD, PORTUGAL Diogo Rocha Carvalho, Md, MsD, PORTUGAL André Santos, MD, PORTUGAL Sérgio Pita, MD, PORTUGAL Filipe Sá Malheiro, MD, PORTUGAL Tiago Pato, PORTUGAL Carlos Filipe Gonçalves João, MD, PORTUGAL Carlos Almeida, PORTUGAL
Total Hip Arthroplasty (THA) after Previous Hip Arthroscopy: A Mid-Term Functional and Clinical Comparison with Index THA Abstract Presentation 5 minutes Kelsi Greenwood, BScHons, SOUTH AFRICA Jurek R. T. Pietrzak, MBBCh, FCS(SA)Orth, UNITED KINGDOM Zia Maharaj, MBChB(Pret), SOUTH AFRICA Josip N. Cakic, MD, PhD, FCS(SA)Orth, MMed(Orth)WITS, SOUTH AFRICA
Sex- And Age-Based Differences In Outcomes And Survivorship Following Primary Hip Arthroscopy At Short And Mid-Term Follow-Up: A Comparative Analysis ePoster Presentation David R. Maldonado, MD, UNITED STATES Jade S Owens, BS, UNITED STATES Cammille Go, BA, UNITED STATES Benjamin G. Domb, MD, UNITED STATES
Characterizing the Incidence of Avascular Necrosis after Corticosteroid Injections of the Hip Abstract Presentation 5 minutes Nathan Varady, MD, MBA, UNITED STATES Paul F Abraham, BS, UNITED STATES Ahab Chopra, BA, UNITED STATES Michael Peter Kucharik, BS, UNITED STATES Wendy Madeline Meek, BBA, 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

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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