Buckling of the hip joint, also referred to as “giving way,” and hip injuries may be associated with hip pain worsening in patients with symptomatic hip osteoarthritis, according to a study published in Arthritis Care & Research.

An internet-based case-crossover study was conducted to evaluate the association between hip injury and “giving way,” or the incidence of joint buckling and perception of sudden postural support loss in the joint, in 133 patients with symptomatic hip osteoarthritis. Participants completed questionnaires at baseline and every 10 days during a 90-day period to assess levels of hip pain. Exacerbation of hip pain was defined as a 2-point increase in pain intensity scores evaluated using a 0 to 10 numeric rating scale.

Participants experienced an average 2.6 hip pain exacerbations during the study period (133 patients reporting 350 exacerbations of hip pain). 

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Having a hip injury vs no injury was found to increase the risk for hip pain exacerbation (odds ratio, 2.74; 95% CI, 1.62-4.62), and hip “giving way” in the last 2 days was also associated with an increased risk for hip pain exacerbation (odds ratio, 2.10; 95% CI, 1.30-3.39). A correlation was established between the number of hip joint buckling events and the risk for hip pain exacerbations (P <.001).

Limitations of the study include the reliance on self-reports and a limited generalizability, considering most patients were Caucasian, had access to the Internet, and were native English speakers.

“The results provide some insight into potential mechanisms of pain exacerbation. Reducing or avoiding activities that lead to hip injury or ‘giving way’ may decrease the risk of hip pain exacerbations in persons with hip [osteoarthritis],” concluded the study authors.

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Fu K, Makovey J, Metcalf B, et al. The role of hip injury and “giving way” in pain exacerbation in hip osteoarthritis: An internet-based case-crossover study [published online July 25, 2018]. Arthritis Care Res (Hoboken). doi: 10.1002/acr.23708