Central Sensitization-Related Symptoms Are Associated With Worse Patient-Reported Outcomes in Patients With Acetabular Labral Tears: A Cross-Sectional Study
Shusuke Nojiri, Masayoshi Saito, Shingo Numajiri, Ren Higashi, Raito Murakawa, Kosuke Hisashi, Naoto Watanabe, Kenji KurosakaBackground:
In patients with acetabular labral tears, hip-specific patient-reported outcomes (PROs) are not always fully explained by structural abnormalities, such as labral tear severity, chondral damage, or bony morphology. Nonstructural factors, including central sensitization (CS)–related symptoms, may also be associated with PROs.
Purpose/Hypothesis:
The purpose of this study was to investigate the association between CS-related symptoms, assessed using the 9-item CS Inventory (CSI-9), and hip-related PROs, assessed using the 12-item International Hip Outcome Tool (iHOT-12), in patients with acetabular labral tears. It was hypothesized that higher CSI-9 scores would be associated with lower iHOT-12 scores.
Study Design:
Cross-sectional study; Level of evidence, 3.
Methods:
This single-center study included patients who presented with groin pain between June 2025 and December 2025, who were clinically suspected of having acetabular labral tears, and who had either magnetic resonance imaging findings suggestive of a labral tear or symptomatic improvement after intra-articular injection. Patients with developmental dysplasia of the hip, radiographic osteoarthritis, subchondral bone marrow lesions suggestive of early degenerative changes, no symptom relief after intra-articular injection, or previous hip surgery were excluded. The iHOT-12 and CSI-9 were completed at the initial clinical assessment. The association between CSI-9 and iHOT-12 scores was examined using Pearson correlation and linear regression analyses.
Results:
A total of 268 patients were included. The mean iHOT-12 and CSI-9 scores were 48.6 ± 21.7 and 12.9 ± 7.0, respectively. In terms of CSI-9 severity categories, mild (10-19) and moderate to severe (≥20) CS-related symptoms were observed in 123 patients (45.9%) and 51 patients (19.0%), respectively. CSI-9 scores were negatively correlated with iHOT-12 scores (
Conclusion:
In patients with acetabular labral tears, higher CSI-9 scores were independently associated with lower iHOT-12 scores, although the correlation was relatively weak. CS-related symptoms were also frequently observed in this population. These findings suggest that CS-related symptoms may be among several factors associated with hip-related PROs in patients with acetabular labral tears.