Assessment of Joint Hypermobility in Adult Patients with Inguinal Hernia: An Analytical Cross Sectional Study from Iraq

Abstract

Background: Weakness of the supporting tissue is one of the causes of inguinal hernia. Joint hypermobility (JHM) is an excessive range of movement of the joint due to laxity of supporting connective tissue.Objective: To assess JHM in adult patients with inguinal hernia.Patients and methods: A total of 200 individuals were included in this study, 100 patients had inguinal hernia diagnosed by a surgeon based on  clinical and abdominal ultrasound examination,  and  another 100 healthy individuals matched in age and  sex were taken as a control group. Age, sex, weight, height, and body mass index (BMI) were recorded. Joint mobility was measured according to Beighton score method for all the participants in the study.Results: The mean age of patients was (35.5± 9.5) year and controls (33.2 ± 10.5) year, All the participants were males. The mean BMI was (25.3 ± 3.1) kg/m² for patients and (25.1 ± 3.8) kg/m² for controls. No statistical significant difference between patients and controls (P>0.05). JHM was significantly more in inguinal hernia patients than in controls (55(55%) vs 20(20%), p<0.001, OR=4.9; 95% CI = 2.6 - 9.2). A multiple logistic regression model was statistically significant and able to predict the group membership with 64% accuracy. Having an average score for joint mobility (4-6) increased the risk of having inguinal hernia by 5.2 times compared to those with negative hypermobility (score<4). Increasing the joint mobility score further to (7-9) increased the risk of having inguinal hernia by 11.3 times compared to those with negative hypermobility (score<4)Conclusions: JHM was significantly more prevalent among Iraqi patients with inguinal hernia patients than controls. A higher score for JHM was associated with a higher risk of developing inguinal hernia.

Keywords: Beighton score; inguinal hernia; joint hypermobility.