Persistent groin pain after hip replacement

The problems of persistent groin pain after Total Hip Arthroplasties (replacement) is a growing concern.  Doctors in Germany revealed troubling complication rates:

Doctors at the Mayo Clinic writing in the Journal of bone and joint surgery suggest that a potential cause of persistent groin pain after total hip arthroplasty is impingement of the iliopsoas tendon. Treatment options include conservative management, tenotomy, and acetabular revision (surgery to adjust or replace the hip socket component).

In looking to suggest treatment options the Mayo doctors looked at 49 patients with a diagnosis of iliopsoas impingement after primary total hip arthroplasty

At the most recent follow-up, 10 patients (50%) in the nonoperative group had groin pain resolution compared with 22 patients (76%) in the operative group

Nonoperative management of iliopsoas impingement led to groin pain resolution in 50% of patients. In patients with minimal acetabular component prominence, iliopsoas release provided a high rate of success.

1 Fink B, Lass R. [Diagnostic Algorithm for Failure Analysis of Painful Total Hip Arthroplasties]. Z Orthop Unfall. 2016 Oct;154(5):527-544. Epub 2016 Oct 11. [Pubmed]

2 Chalmers BP, Sculco PK, Sierra RJ, Trousdale RT, Berry DJ. Iliopsoas Impingement After Primary Total Hip Arthroplasty: Operative and Nonoperative Treatment Outcomes. J Bone Joint Surg Am. 2017 Apr 5;99(7):557-564. [Pubmed]

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