[Internal coxa saltans in total hip arthroplasty. Case report]

Coxa saltans or snapping hip, in its internal and external varieties, is a well-known syndrome in the coxofemoral orthopedic pathology. The internal variety is less frequent and is rather unusual after a total hip arthroplasty (THA). This disorder is often times mistaken with chronic groin pain after a THA. This paper describes a typical case of snapping hip in the setting of THA and helps recognize the clinical differences between both entities, with a description of the signs and symptoms that characterize them. In order to support the etiology and pathogenesis, the diagnosis and treatment, we include anatomical considerations concerning the variants of the iliopsoas musculo-tendinous complex attachment, its relations with the articular capsule and the iliopectineal bursa. The role of implant malpositioning in this entity is reviewed and the usefulness of various diagnostic and treatment methods is discussed.