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Evaluation of persistent pain after hip resurfacing
Vassilios Nikolaou1, Stephane G Bergeron, Olga L Huk
1Division of Orthopaedic Surgery, McGill University Health Centre, Montreal, Quebec, Canada.
Bulletin of the NYU Hospital for Joint Diseases
|July 9, 2009
Summary
Diagnosing pain after hip resurfacing arthroplasty requires a thorough evaluation. Key steps include history, physical exam, imaging, and lab tests to identify causes like fractures or metal sensitivity.
Area of Science:
- Orthopaedic Surgery
- Biomedical Engineering
Background:
- Hip resurfacing arthroplasty is an alternative to total hip replacement for younger patients.
- Pain following hip resurfacing can be complex to diagnose and manage.
Purpose of the Study:
- To outline the diagnostic process for pain after hip resurfacing.
- To highlight common and less common causes of hip pain post-surgery.
Main Methods:
- Detailed patient history and physical examination.
- Review of serial radiographs to detect loosening, migration, or osteolysis.
- Diagnostic injections, bone scintigraphy, hip aspiration, and laboratory tests (ESR, CRP) to rule out infection.
- Advanced imaging (US, MRI) and arthroscopy for suspected metal sensitivity.
Main Results:
- Femoral neck fractures and metal hypersensitivity are crucial considerations for persistent groin pain.
- Iliopsoas tendinopathy and anterior impingement are recognized causes of pain.
- A systematic approach is essential for accurate diagnosis.
Conclusions:
- Accurate diagnosis of pain following hip resurfacing is vital for timely and appropriate treatment.
- Recognizing diverse etiologies, including mechanical issues, infection, and hypersensitivity, is key.