Abstract
Introduction: Resurfacing arthroplasty is rapidly gaining popularity, the patients are in many cases very satisfied with the result. However some patients continue to complain about persistent groin pain, which is not clearly understood and attruibuted to different causes.
We identified femoro-acetabular impingement as a source of pain, which promptly disappeared after surgical off-set restoration.
Method: Since 2002 we implanted 390 hip resurfacing systems. At a one-year follow-up 16 patients complained about groin pain, especially when starting to walk.
In 6 patients the clinical examination and the rx could demonstrate femoro-acetabular impingement. In four cases this was due to anterior osteophytes of the femoral neck, in two cases it was due to retroversion of the femoral implant. These 6 patients were revised.
Results: During surgery femoro-acetabular impingement between these osteophytes on the femoral neck and the acetabular rim or the implant could be demonstrated. The head-neck off-set was restored with a high-speed burr. Interestingly rapid bleeding of the femoral neck was noted in all cases confirming the presence of vital bone. After surgery five of the six patients were painfree after 6–12 weeks. One patient did not experience a difference until now. There were no femoral neck fractures seen after this procedure.
Conclusion: Femoro-acetabular impingement seems to be a common source of persistent groin pain after hip resurfacing. Care has to be taken to restore the head-neck offset during implantation.
Correspondence should be addressed to Ms Larissa Welti, Scientific Secretary, EFORT Central Office, Technoparkstrasse 1, CH-8005 Zürich, Switzerland
