Psychological factors play a critical role in patient presentation, satisfaction, and outcomes. Pain catastrophizing, anxiety, and depression are important to consider, as they are associated with poorer outcomes and are potentially modifiable. The aim of this study was to assess the level of pain catastrophizing, anxiety, and depression in patients with a range of hip pathology and to evaluate their relationship with patient-reported psychosocial and functional outcome measures. Patients presenting to a tertiary-centre specialist hip clinic were prospectively evaluated for outcomes of pain catastrophizing, anxiety, and depression. Validated assessments were undertaken such as: the Pain Catastrophizing Scale (PCS), the Hospital Anxiety Depression Scale (HADS), and the 12-Item Short-Form Health Survey (SF-12). Patient characteristics and demographics were also recorded. Multiple linear regression modelling, with adaptive least absolute shrinkage and selection operator (LASSO) variable selection, was used for analysis.Aims
Patients and Methods
Deficiency of the abductor mechanism is a well-recognised
cause of pain and limping after total hip replacement (THR). This
can be found incidentally at the time of surgery, or it may arise
as a result of damage to the superior gluteal nerve intra-operatively,
or after surgery owing to mechanical failure of the abductor muscle
repair or its detachment from the greater trochanter. The incidence
of abductor failure has been reported as high as 20% in some studies.
The management of this condition remains a dilemma for the treating
surgeon. We review the current state of knowledge concerning post-THR
abductor deficiency, including the aetiology, diagnosis and management,
and the outcomes of surgery for this condition. Cite this article:
Fifteen patients with identical symptoms of pain and tenderness at the tip of the greater trochanter are reviewed. Diagnosis by the referring doctor was usually osteoarthritis of the hip or sciatica, but localised tenderness and pain on resisted abduction were the only clinical signs. Radiographs were usually normal. Most cases were relieved by one or more local steroid injections. This disorder has much in common with tennis elbow, golfer's elbow, coccydynia and policeman's heel. We suggest that all these conditions may be traction syndromes.
