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The Prevalence of Groin Pain After Metal-on-Metal Total Hip Arthroplasty and Total Hip Resurfacing

  • Symposium: Complications of Hip Arthroplasty
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

Groin pain after total hip arthroplasty (THA) or total hip resurfacing arthroplasty can be troubling for patients and surgeons. Potential sources of pain include infection, loosening, metal hypersensitivity, or im**ement of bony structures or the iliopsoas tendon.

Questions/purposes

We compared the rate of groin pain after THA or hip resurfacing using metal-on-metal to those of other bearing surfaces.

Methods

We identified 347 (334 patients) primary total hip (n = 301) or resurfacing (n = 46) arthroplasties. Complete preoperative, operative, and postoperative data were available for 282 hips. We retrospectively reviewed the charts for the presence or absence of groin pain at a minimum of 1 year after surgery with a specific focus on etiologic factors. The minimum followup was 12 months (mean, 14 months; range 12 to 24 months).

Results

The rate of groin pain was 7% (15 of 217 patients) after THA with conventional bearing surfaces, 15% (4 of 26 patients) with metal-on-metal THA and 18% (7 of 39 patients) with total hip resurfacing. Younger patients were more likely to report groin pain postoperatively and more likely to have metal-on-metal bearing surfaces.

Conclusions

Our data at short-term followup suggest increased rates of groin pain after metal-on-metal THA or resurfacing arthroplasty versus THA using polyethylene or ceramic bearing surfaces. The reasons are not clear but they appear to be associated with younger age. Potential factors include im**ement, activity level and possibly higher expectations for patients receiving metal-on-metal bearing surfaces that may make those patients more likely to report postoperative pain.

Level of Evidence

Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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Acknowledgments

We thank Dirk Larson, MS for assistance with statistical analysis.

Author information

Authors and Affiliations

  1. Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA

    Robert B. Bartelt MD, Brandon J. Yuan MD, Robert T. Trousdale MD & Rafael J. Sierra MD

Authors
  1. Robert B. Bartelt MD
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  2. Brandon J. Yuan MD
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  3. Robert T. Trousdale MD
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  4. Rafael J. Sierra MD
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Corresponding author

Correspondence to Rafael J. Sierra MD.

Additional information

One or more of the authors (RTT, RJS) has received funding from DePuy, Wright Medical Technologies, or Biomet. The institution of the authors has received funding from DePuy, Zimmer and Stryker. Each author certifies that he or she has or may receive payments or benefits from a commercial entity related to this work.

Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research.

Appendices

Appendix 1

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Appendix 2

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Bartelt, R.B., Yuan, B.J., Trousdale, R.T. et al. The Prevalence of Groin Pain After Metal-on-Metal Total Hip Arthroplasty and Total Hip Resurfacing. Clin Orthop Relat Res 468, 2346–2356 (2010). https://doi.org/10.1007/s11999-010-1356-y

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  • DOI: https://doi.org/10.1007/s11999-010-1356-y

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