THE PAINFUL HIP: DIAGNOSIS AND DELIVERANCE

S.J. MacDonald

doi:10.1302/1358-992X.95BSUPP_22.CCJR2012-040

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General Orthopaedics

THE PAINFUL HIP: DIAGNOSIS AND DELIVERANCE

Current Concepts in Joint Replacement (CCJR) – Winter 2012

S.J. MacDonald

THE PAINFUL HIP: DIAGNOSIS AND DELIVERANCE

MacDonald S. THE PAINFUL HIP: DIAGNOSIS AND DELIVERANCE. Orthop Procs. 2013;95-B(SUPP_22):40-40. doi:10.1302/1358-992X.95BSUPP_22.CCJR2012-040

MacDonald, S.J.. “THE PAINFUL HIP: DIAGNOSIS AND DELIVERANCE.” Orthopaedic Proceedings, vol. 95-B, no. SUPP_22, 2013, pp. 40-40., https://doi.org/10.1302/1358-992X.95BSUPP_22.CCJR2012-040

MacDonald, S. (2013). THE PAINFUL HIP: DIAGNOSIS AND DELIVERANCE. Orthopaedic Proceedings, 95-B(SUPP_22), 40-40. https://doi.org/10.1302/1358-992X.95BSUPP_22.CCJR2012-040

MacDonald, S. (2013) “THE PAINFUL HIP: DIAGNOSIS AND DELIVERANCE.” Orthopaedic Proceedings, 95-B(SUPP_22), pp. 40-40. Available at: https://doi.org/10.1302/1358-992X.95BSUPP_22.CCJR2012-040

MacDonald, S.J. “THE PAINFUL HIP: DIAGNOSIS AND DELIVERANCE.” Orthopaedic Proceedings 95-B, no. SUPP_22 (2013): 40-40. https://doi.org/10.1302/1358-992X.95BSUPP_22.CCJR2012-040

MacDonald S. THE PAINFUL HIP: DIAGNOSIS AND DELIVERANCE. Orthop Procs. 2013 May 1;95-B(SUPP_22):40-40. https://doi.org/10.1302/1358-992X.95BSUPP_22.CCJR2012-040

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Abstract

Pain following total hip arthroplasty is a relatively rare event. Several series place the incidence of some degree of pain post THA at approximately 5%.

A systematic approach to determining etiology will direct treatment. Hip pain can be categorised as:

Extrinsic to the Hip

–

Spine +/− radiculopathy
–

Vascular disease
–

Metabolic (Paget's)
–

Malignancy

Intrinsic to the Hip

Intracapsular/Implant

Loosening
Sepsis
Prosthetic failure
Osteolysis
Instability
Thigh pain
Stem tip pain
Hypersensitivity/ALVAL

Extracapsular

Iliopsoas tendonitis
Snapping Hip
Trochanter problems (bursitis)
Heterotopic ossification

A full history and appropriate physical exam will direct the clinician. The use of routine radiographs, blood tests, and special tests (i.e., blood metal ions, advanced imaging techniques) will be discussed I detail.