Bupivicaine arthrography of the post-arthroplasty hip

Addition of bupivicaine, a medium-length-acting local anesthetic, to the contrast material in arthrography of total hip prostheses provides reliable information as to whether the source of pain is intracapsular or extracapsular. In 12 surgically proven cases, complete relief of pain after bupivicaine injection correctly identified an intracapsular source of pain in 10, with only 1 false-positive and 1 false-negative. These results compare favorably with the results of the contrast arthrograms in these patients in localizing the pain even if a specific diagnosis could not be reached. Bupivicaine as an adjunct to contrast material during arthrography provides additional information useful in management decisions regarding the necessity of revision arthroplasty.