The painful hip: diagnosis and deliverance.

Abstract

The differential diagnosis of the painful total hip arthroplasty (resurfacing or total hip) includes infection, failure of fixation (loosening), tendinitis, bursitis, synovitis, adverse local tissue reaction (ALTR) to cobalt-chromium alloys, and non-hip issues, such as spinal disorders, hernia, gynecologic, and other pelvic pain. Assuming that the hip is the source of pain, the first level question is prosthetic or non-prosthetic pain generator? The second level prosthetic question is septic or aseptic? The third level question (aseptic hips) is well-fixed or loose? ALTR is best diagnosed by cross-sectional imaging. Successful treatment is dependent on correct identification and elimination of the pain generator. Treatment recommendations for ALTR and taper corrosion are evolving.

• Authors: T P Schmalzried
• Journal: The Journal of bone and joint surgery. British volume (J Bone Joint Surg Br) Vol. 94 Issue 11 Suppl A Pg. 55-7 (Nov 2012) ISSN: 2044-5377 [Electronic] England
• PMID: 23118382 (Publication Type: Journal Article, Review)

Topics

• Arthroplasty, Replacement, Hip (instrumentation)
• Diagnosis, Differential
• Hip Prosthesis (adverse effects)
• Humans
• Pain, Postoperative (etiology)
• Postoperative Complications (diagnosis, etiology, therapy)
• Prosthesis Failure
• Prosthesis-Related Infections (diagnosis, therapy)