The Prevalence of Groin Pain After Metal-on-Metal THA and Total Hip Resurfacing
Robert B. Bartelt MD, Brandon J. Yuan MD, Robert T. Trousdale MD, Rafael J. Sierra MD
Clinical Orthopaedics and Related Research, Volume 468, Number 9, September 2010
Background Groin pain after total hip arthroplasty (THA) or total hip resurfacing arthroplasty can be troubling for patients and surgeons. Potential sources of pain include infection, loosening, metal hypersensitivity, or impingement of bony structures or the iliopsoas tendon.
Questions/purposes We compared the rate of groin pain after THA or hip resurfacing using metal-on-metal to those of other bearing surfaces.
Methods We identified 347 (334 patients) primary total hip (n = 301) or resurfacing (n = 46) arthroplasties. Complete preoperative, operative, and postoperative data were available for 282 hips. We retrospectively reviewed the charts for the presence or absence of groin pain at a minimum of 1 year after surgery with a specific focus on etiologic factors. The minimum followup was 12 months (mean, 14 months; range 12 to 24 months).
Results The rate of groin pain was 7% (15 of 217 patients) after THA with conventional bearing surfaces, 15% (4 of 26 patients) with metal-on-metal THA and 18% (7 of 39 patients) with total hip resurfacing. Younger patients were more likely to report groin pain postoperatively and more likely to have metal-on-metal bearing surfaces.
Conclusions Our data at short-term follow up suggest increased rates of groin pain after metal-on-metal THA or resurfacing arthroplasty versus THA using polyethylene or ceramic bearing surfaces. The reasons are not clear but they appear to be associated with younger age. Potential factors include impingement, activity level and possibly higher expectations for patients receiving metal-on-metal bearing surfaces that may make those patients more likely to report postoperative pain.
Level of Evidence Level IV, therapeutic study.
- Minimal Incision Surgery as a Risk Factor for Early Failure of Total Hip Arthroplasty
- Wear and Range of Motion of Different Femoral Head Sizes
- Restoration of the Center of Rotation in Revision Total Hip Arthroplasty
- The Prevalence of Groin Pain After Metal-on-Metal THA and Total Hip Resurfacing
- Metal-on-Metal Hip Arthroplasty in Patients Thirty Years of Age or Younger
- Current Concepts Review Metal-on-Metal Total Hip Arthroplasty
- Revision of Failed Total Hip Arthroplasty Acetabular Cups to Porous Tantalum Components
- Risk of Complication and Revision THA Among Medicare Patients
- Optimal acetabular orientation for hip resurfacing