Groin Pain After THA

Description

Professor Dominic Meek gives his expert insights and discusses the case of a 60-year-old patient experiencing groin pain following a previous hip replacement. The pain intensifies with hip flexion, particularly during activities such as getting in and out of a car or navigating stairs. This symptom is likely linked to iliopsoas pain, which occurs due to irritation of the iliopsoas tendon as it passes over the acetabular component of the hip implant. A CT scan indicates that the acetabular component is correctly sized and positioned, but the evaluation might not accurately represent the component's behavior in different positions, such as sitting or standing. The suggested next steps include confirming the diagnosis of iliopsoas bursitis through ultrasound or MRI. Literature suggests that ultrasound-guided steroid injections can alleviate symptoms for about 80% of patients, but repeated injections are often less effective. If the patient's symptoms persist, consultation with an orthopedic specialist for possible arthroscopic debridement or division of the iliopsoas tendon is recommended, though this might result in some loss of hip flexion strength. Revision of the acetabular component is possible but considered a major procedure, thus making arthroscopic treatment the more favorable option for most patients.


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DOI: 10.1302/3114-251274

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