title: Investigation and macroscopic anatomical study of referred pain in patients with hip disease.
abstract: [Purpose] The aim of this study was to examine the incidence and patterns of referred pain in patients with hip disease, as well as the nerve distribution in the hip and knee joints of 2 cadavers. [Subjects and Methods] A total of 113 patients with hip joint disease were included in the investigation. The incidence of regional pain and referred pain patterns were evaluated before and after arthroplasty. Two cadavers were macroscopically observed to verify the nerve innervation of the hip and knee joints. [Results] Anterior knee pain was observed preoperatively in 13.3% (in resting) and 33.6% (in motion) of the patients, which was comparable with the incidence of greater trochanter pain. In addition, the preoperative incidence rates of knee pain in resting and motion markedly decreased postoperatively. Of note is the remarkable incidence of pain radiating to the ventral lower limb. An anteromedial innervation was determined in the cadavers by the articular branches of the obturator and femoral nerve, which supply small branches to the knee joints. [Conclusion] Our results suggest that the distribution of the incidence of pain among the patients with hip disease is diverse owing to the sensory distribution of the femoral and obturator nerves.
authors.affiliation: Department of Rehabilitation, Nagasaki University Hospital, Japan.
authors.forename: Junya
authors.initials: J
authors.lastname: Sakamoto
authors.affiliation: Department of Rehabilitation, Nagasaki University Hospital, Japan ; Department of Locomotive Rehabilitation Science, Unit of Rehabilitation Sciences, Nagasaki University Graduate School of Biomedical Sciences, Japan.
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Morimoto
authors.affiliation: Department of Rehabilitation, Nagasaki University Hospital, Japan.
authors.forename: Shun
authors.initials: S
authors.lastname: Ishii
authors.affiliation: Department of Physical Therapy Science, Unit of Physical and Occupational Therapy, Nagasaki University Graduate School of Biomedical Sciences, Japan.
authors.forename: Jiro
authors.initials: J
authors.lastname: Nakano
authors.affiliation: Department of Oral Anatomy and Dental Anthropology, Unit of Basic Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Japan.
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Manabe
authors.affiliation: Department of Locomotive Rehabilitation Science, Unit of Rehabilitation Sciences, Nagasaki University Graduate School of Biomedical Sciences, Japan.
authors.forename: Minoru
authors.initials: M
authors.lastname: Okita
authors.affiliation: Department of Macroscopic Morphology, Unit of Basic Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Japan.
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Tsurumoto
keywords: Hip joint disease; Macroscopic anatomy; Referred pain