Knee OA: CPR for Hip Mobs

Purpose

Clinical prediction rules (CPRs) are certain signs and symptoms that can be combined to help clinicians narrow down the likelihood of a specific diagnosis or classification so that appropriate treatment may be directed to facilitate a timely and effective outcome.  Currier et al presented a level IV study in 2007 that favors at least a short term decrease in pain in people that have knee osteoarthritis.

Clinical Prediction Rule Variables

 1. Hip or groin pain or parasthesias

2. Ipsilateral anterior thigh pain

3. Passive knee flexion < 122 deg

4. Passive hip internal rotation < 17 deg

5. Pain with hip distraction

Evidence

Variable	Sensitivity (95% CI)	Specificity (95% CI)	+ Likelihood Ratio	- Likelihood Ratio
Hip/groin pain/numbness	0.15	0.98	6.19	0.87
Anterior thigh pain	0.27	0.95	5.1	0.77
PROM <122 deg knee flex	0.32	0.95	6.02	0.72
PROM < 17 deg hip IR	0.32	0.95	6.02	0.72
Pain with hip distraction	0.13	0.98	5.24	0.89

Based on the pretest probability of success, which was 68%, the presence of one variable being present  increased a successful response to 92%.  If 2 variables were present, the probability of success increased to 97%.   It is interesting to note that in the 60 subjects that were involved in this study, none had more than 3 variables that were positive.