Generalized Joint Hypermobility in Adults: A Systematic Review With Meta-Analysis to Identify Data-Driven Cut-offs Using the Beighton Score.

Abstract

The aim of this study was to systematically review the literature and undertake a meta-analysis to describe joint hypermobility, measured by Beighton score, in the general adult population and identify appropriate cut-offs to use for screening for generalized joint hypermobility (GJH). We searched Allied and Complementary Medicine, Ovid MEDLINE, Embase, and CINAHL from inception to June 2024. We included studies reporting Beighton score in the general population and adults ≥18 years. We extracted country of data collection, age, sex, and Beighton score data. Data were grouped into participant ages. Meta-analysis was performed when two or more studies were available. We considered 2.5% prevalence as an indicator for typical variance. There were 46 studies (n = 23,000), with 38 studies included in the age group analysis and 45 studies included in the analysis by sex. Overall, GJH prevalence at six or more of nine was 2% (95% confidence interval [CI] 0.6-6.6) and considered the threshold score indicating GJH outside typical variance. Subanalysis of age groups indicated a prevalence of 5.0% (95% CI 1.2-18.0) at six or more for young adults (18-25 years). For adults (26-65 years), five or more indicated a prevalence of 1.5% (95% CI 0.2-9.5), and older adults (≥65 years) had a prevalence of 6.5% (95% CI 5.5-7.7) at four or more, higher than the threshold, but there were insufficient data for meta-analysis of five or more. There were no statistically significant differences between female and male subjects at any cut-off (all P ≥ 0.17). Beighton score cut-offs should vary with age. For adults 18 to 25 years old, 26 to 65 years old, and >65 years old, Beighton score cut-offs to screen for GJH should be six or more of nine, five or more of nine, and four or more of nine, respectively.