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Groin pain following hip resurfacing: a case-control study
John R McArthur1, Matthew Costa, Damian R Griffin
1Department of Orthopaedic Surgery, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK. john.mcarthur@hotmail.com
Summary
Hip resurfacing patients with groin pain showed poor functional outcomes. Pain was linked to stem positioning and metal ion levels, differentiating between biological and mechanical causes.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
- Medical Imaging
Background:
- Hip resurfacing arthroplasty is a common procedure for hip osteoarthritis.
- Groin pain is a potential complication following hip resurfacing.
- Identifying the causes of groin pain is crucial for patient management.
Purpose of the Study:
- To investigate the factors associated with groin pain after hip resurfacing.
- To differentiate between biological and mechanical causes of pain.
- To correlate clinical findings with implant positioning and metal ion levels.
Main Methods:
- Comparison of 47 patients with groin pain to a matched control group.
- Assessment of functional outcomes, plain radiographs, and whole blood cobalt and chromium levels.
- Ultrasound scans of symptomatic hips to identify soft tissue abnormalities.
Main Results:
- Patients with groin pain had significantly poorer functional outcomes compared to controls.
- Groin pain correlated with valgus stem positioning and lower neck:head ratio.
- Two distinct subgroups emerged: biological (soft tissue abnormalities, higher metal ions) and mechanical (normal ultrasound, lower metal ions, retroverted components).
Conclusions:
- Groin pain following hip resurfacing is multifactorial, with distinct biological and mechanical etiologies.
- Implant positioning and metal ion levels are key indicators.
- Ultrasound and metal ion analysis aid in classifying pain causes for targeted treatment.
