Groin Pain after Metal on Metal Hip Resurfacing: Mid-Term Follow-Up of a Prospective Cohort of Patients

Emmanuel Illical, MD, FRCSC
Division of Orthopaedic Surgery, Ottawa, ON, Canada

Healther Belanger, RN
Division of Orthopaedic Surgery, Ottawa, ON, Canada

Paul R. Kim, MD, FRCSC
Division of Orthopaedic Surgery, Ottawa, ON, Canada

Paul E. Beaule, MD, FRCSC
Division of Orthopaedic Surgery, Ottawa, ON, Canada


Abstract

Background and Purpose: 
Groin pain after metal on metal hip resurfacing has been previously reported. The purpose of this study was to determine the natural history of a cohort of patients with groin pain after hip resurfacing previously reported on and incidence of revision surgery.

Methods: 
Our group previously reported an 18% incidence of groin pain at a mean of 18 months post hip resurfacing. This cohort of groin pain patients was prospectively followed. Patients were evaluated using a visual analog pain rating score, the University of California at Los Angeles (UCLA) Physical Activity Index, and the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) Index. Functional outcome scores were compared from initial to latest follow up using the paired Studentís t test. Further diagnostic evaluation and/or intervention or other complication was also recorded.

Results: 
The latest mean follow up from surgery was 63±15 months. The mean pain rating, UCLA, and WOMAC scores all improved at latest follow up, although WOMAC score improvement was not statistically significant. Mean pain rating score improved from 5.2±2.0 to 2.5±1.4 (p=0.0001). UCLA activity score improved from 6.4±2.0 to 6.9±1.6 (p=0.03). Total WOMAC score improved from 75.6±20.5 to 84.5±14.8 (p=0.15). Only one patient was revised for an adverse local tissue reaction.

Conclusion: 
Groin pain post hip resurfacing has a multifactorial etiology, and in the vast majority of cases improves over time with no significant functional limitations. However, the surgeon should be aware of the many potential causes, and help minimize the possibility with proper patient selection and surgical technique.

This article appears in HSS Journal: Volume 8, Number 3.
View the full article at springerlink.com.

About the HSS Journal

HSS Journal, an academic peer-reviewed journal published three times a year, February, July and October. The Journal accepts and publishes peer reviewed articles from around the world that contribute to the advancement of the knowledge of musculoskeletal diseases and disorders.

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