Pain Perception in Hip Osteoarthritis

James Powell, Pamela Railton, Andrew Delaney

Research output: Other contribution to conferencePosterpeer-review


It is recognized that there is a poor correlation between a patient’s perception of their pain and the findings on plain x-rays of the hip. This study defines brain connectivity networks in patients with chronic pain related to osteoarthritis of the hip using resting state fMRI.
Thirty hip OA patients (17 M, 13 F; age range: 38-71) scheduled for total hip replacement and 10 age-matched controls (4 M, 6 F) were recruited. Using visual analogue scale of 0 to 10, patients graded their average pain over the previous 4 weeks. Patients underwent resting -state fMRI, using a 3 Tesla GE Discovery MR750 scanner (GE Healthcare, Waukesha, WI). Patients were then removed from the scanner, climbed stairs and engaged in squats and lunges to provoke pain. They then returned to the scanner for a second scan.
Based on a recent fMRI study of pain, the dorsal anterior cingulate cortex (dACC), secondary somatosensory cortex (S2), anterior and posterior insula, and thalamus were selected as regions of interest (ROIs) and were defined on each participant’s anatomical images with the aid of an atlas. For each ROI, resting state brain connectivity was compared between hip OA patients and controls, using a mixed-effects GLM analysis. Results were presented as brain maps of the Z-score of the difference in connectivity, corrected for multiple comparisons using a false discovery rate (FDR) of 0.05.
Relative to controls, connectivity between S2 and the left posterior insula was increased in hip OA patients. Connectivity was reduced between the posterior insula and the hip area of the primary motor and sensory cortices.
Resting-state fMRI defines the brain signature for chronic pain secondary to OA of the hip joint. Fmri could be used as a primary tool to investigate central pain perception in patients with hip OA.
Original languageEnglish
Publication statusPublished - 2018
Event2018 AAHKS Annual Meeting - Hilton Anatole, Dallas, United States
Duration: 01 Nov 201804 Nov 2018 (link to meeting resources)


Conference2018 AAHKS Annual Meeting
Country/TerritoryUnited States
OtherThe American Association of Hip and Knee Surgeons (AAHKS) had a very successful and productive Annual Meeting at the Hilton Anatole in Dallas from November 1-4, 2018 with 3,500 people in attendance. The goal of the Annual Meeting is for surgeons to learn about the latest research and techniques in adult reconstruction (total joint replacement) and bring actionable insights back to their practices. The size and scope of the 2018 AAHKS Annual Meeting continued to trend upward with an 11% growth in attendance compared to 2017. Representatives of the British Hip Society and Italian Hip Society participated as the 2018 Guest Societies and co-hosted the popular International Reception that brings together member surgeons from around the world.
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