Today's News

Wednesday, February 28, 2001

Groin pain not specific in cases of failed THA

A study of pain patterns in patients with a failed total hip arthroplasty finds groin pain is not specific for acetabular component loosening.

Fifty-seven patients undergoing revision hip arthroplasty were evaluated with a standard preoperative questionnaire prior to surgery and filled out a pain diagram, said investigators in poster exhibit 328. Operative findings of loosening were documented from clinical, operative and radiology reports. ANOVA and Stepwise multiple regression analysis was performed for the statistical analysis. A p value > 0.05 was considered significant.

The study disclosed that 52.6 percent of patients complained of pain in the groin; 47.4 percent, buttock; 36.8 percent, lateral thigh; 15.8 percent, anterior thigh; 17.5 percent, medial thigh; 5.3 percent, posterior thigh; 19.3 percent, knee; and 3.5 percent, whole leg pain.

Intraoperatively, 56.1 percent had the acetabular component loose, 8.8 percent had fibrous ingrowths and 24.6 percent had a well-fixed component; 45.6 percent had femoral component loosening, 10.5 percent had fibrous ingrowths and 40.4 percent had a well-fixed femoral component.

Anterior (p = 0.02) and lateral thigh pain (p = 0.04) associated with groin pain (p = 0.04) was found to be the most important predictors of radiographic and intraoperative femoral component loosening.

"Our results demonstrate that, groin pain is not specific for acetabular component loosening, the coauthors said. "Radiographic evidence of loosening of the femoral component is strongly associated with lateral or anterior thigh pain associated with groin pain. The pain diagram is a cheap and useful preoperative test."

The coauthors are Carlos J. Lavernia, MD, associate professor of orthopaedic surgery and biomedical engineering, director, division of arthritis surgery, department of orthopaedic rehabilitation University of Miami School of Medicine, Miami, Fla,; Ruben A. Hernandez, MD, orthopaedic surgery resident PGY-1, department of orthopaedic surgery, University of Puerto Rico, School of Medicine, San Juan, Puerto Rico; and Rafael J. Sierra, MD, orthopaedic surgery resident, PGY-1, department of orthopaedic surgery, Mayo Clinic, Rochester, Minn.

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2001 Academy News February 28 Index B

Last modified 20/February/2001 by IS