Evaluation of the painful total hip arthroplasty

Total hip arthroplasty is a common technique for the surgical management of degenerative hip disease. Because of the increasing number of patients and the variety of prostheses and fixation modalities available to the surgeon, the evaluation of the patient with a painful arthroplasty has become an increasingly complex endeavor. The growing number of patients who undergo multiple revision surgeries further complicates the evaluation of the painful arthroplasty. Other complicating factors include the lack of absolute sensitivity and specificity of the variety of diagnostic techniques and the difficulty of differentiating pain caused by septic verses aseptic loosening. This report reviews the recent literature concerning the evaluation of the painful total hip arthroplasty and provides a clinical rationale for the assessment of the painful total hip arthroplasty.