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Related Experiment Video

Updated: Jun 21, 2026

The Transition to an Anterior-Based Muscle Sparing Approach Improves Early Postoperative Function but is Associated with a Learning Curve

The Transition to an Anterior-Based Muscle Sparing Approach Improves Early Postoperative Function but is Associated with a Learning Curve

Published on: September 7, 2022

[Obturator externus impingement after total hip replacement].

M Müller¹, C Perka, S Tohtz

¹Centrum für Muskuloskeletale Chirurgie, Klinik für Orthopädie, Klinik für Unfall- und Wiederherstellungschirurgie, Charité-Universitätsmedizin Berlin, Chariteplatz 1, 10117, Berlin, Deutschland. michael.mueller@charite.de

|August 15, 2009

Summary

Painful total hip replacement can be caused by rare muscle impingement. This case highlights obturator externus muscle impinging on the acetabular cup, confirmed by imaging and injection.

Related Experiment Videos

Last Updated: Jun 21, 2026

The Transition to an Anterior-Based Muscle Sparing Approach Improves Early Postoperative Function but is Associated with a Learning Curve

The Transition to an Anterior-Based Muscle Sparing Approach Improves Early Postoperative Function but is Associated with a Learning Curve

Published on: September 7, 2022

Area of Science:

Orthopedic Surgery
Musculoskeletal Imaging
Diagnostic Challenges in Arthroplasty

Background:

Total hip replacement (THR) complications can present diagnostic challenges, especially when loosening is not evident.
Psoas impingement syndrome is a recognized, albeit rare, cause of pain after THR.
Periarticular muscle impingement represents a spectrum of potential complications following arthroplasty.

Observation:

A patient presented with persistent pain after THR, without signs of implant loosening.
Magnetic resonance imaging (MRI) revealed abnormal contact between the obturator externus muscle and the acetabular cup.
The patient experienced pain localized to the area of the observed muscle-cup contact.

Findings:

The study identified obturator externus muscle impingement as the cause of hip arthroplasty pain.
Pathologic contact between the obturator externus muscle and the acetabular cup was visualized on MRI.
Diagnostic anesthetic injection into the affected area confirmed the source of pain.

Implications:

Obturator externus muscle impingement should be considered in the differential diagnosis of painful THR.
Advanced imaging like MRI is crucial for identifying rare soft tissue impingement causes.
Accurate diagnosis through imaging and targeted injections can guide appropriate treatment for post-arthroplasty pain.