Anterior iliopsoas impingement due to a malpositioned acetabular component - effective relief by surgical cup reorientation

Hip Int. 2017 Mar 31;27(2):128-133. doi: 10.5301/hipint.5000443. Epub 2016 Nov 18.

Abstract

Background: Determining the aetiology of persistent pain following total hip arthroplasty (THA) can be challenging. Impingement of the iliopsoas muscle due to a malpositioned acetabular component after THA might be a potential cause of postoperative groin pain.

Methods: We retrospectively analysed the data of 12 consecutive patients from our orthopaedic department who underwent cup revision for painful iliopsoas impingement after primary THA.

Results: Thorough physical examination as well as radiological assessment of the included patients revealed that malpositioning of the acetabular component provoked iliopsoas impingement.The Harris Hip Score and the orientation of the acetabular component before and after surgical revision at an average follow-up of 56 months were analysed.

Conclusions: We were able to demonstrate that surgical cup revision and reorientation resulted in distinctly improved scores and is a feasible option to effectively treat persistent iliopsoas impingement due to a malpositioned acetabular component following THA.

MeSH terms

  • Acetabulum / physiopathology
  • Acetabulum / surgery*
  • Adult
  • Aged
  • Arthroplasty, Replacement, Hip / adverse effects*
  • Arthroplasty, Replacement, Hip / methods
  • Chronic Pain / etiology
  • Chronic Pain / surgery
  • Cohort Studies
  • Female
  • Femoracetabular Impingement / diagnostic imaging
  • Femoracetabular Impingement / etiology
  • Femoracetabular Impingement / surgery*
  • Follow-Up Studies
  • Hip Prosthesis*
  • Humans
  • Male
  • Middle Aged
  • Pain Measurement
  • Prosthesis Failure
  • Reoperation / methods*
  • Retrospective Studies
  • Risk Assessment
  • Treatment Outcome