Incidence and Risk Factors of Iliopsoas Tendinopathy After Total Hip Arthroplasty: A Radiographic Analysis of 1,602 Hips |
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| Institution: | 1. Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea;2. Department of Orthopedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea;1. Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, Pennsylvania;2. Department of Orthopaedics & Sports Medicine, Maine Medical Partners, South Portland, Maine;3. OrthoCarolina, Charlotte, North Carolina;4. American Association of Hip and Knee Surgeons, Chicago, Illinois;1. Department of Orthopaedic Surgery, George Washington University Hospital, Washington, District of Columbia;2. Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland;1. Ortopedia-Traumatologia e Chirurgia protesica e dei reimpianti d''anca e di ginocchio, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy;2. Laboratorio di Tecnologia Medica, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy;3. DIBINEM, University of Bologna, Bologna, Italy;1. Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee;2. Department of Orthopaedic Surgery, University of Utah Health, Salt Lake City, Utah;3. Department of Orthopaedic Surgery, Carolinas Medical Center, Charlotte, North Carolina;1. Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, Louisiana;2. Department of Orthopaedic Surgery, Emory University School of Medicine, Atlanta, Georgia |
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| Abstract: | BackgroundIliopsoas tendinopathy (IPT) can cause persistent groin pain and lead to dissatisfaction after total hip arthroplasty (THA). This study aimed to report the characteristics, incidences, risk factors, and treatment outcomes of IPT after THA.MethodsWe reviewed primary THAs performed at a single institution between January 2012 and May 2018. Clinical and radiographic analyses were performed on 1,602 THAs (1,370 patients). Patient characteristics, component sizes, inclination and anteversion angles, and antero-inferior cup prominence (≥8 millimeters (mm)), were compared between the groups with and without IPT. Changes in teardrop to lesser trochanter distance were measured to estimate changes in leg length and horizontal offset caused by THA. Logistic regression models were used to identify the risk factors for IPT. IPT was identified in 53 hips (3.3%).ResultsPatients with IPT had greater leg lengthening (12.3 versus 9.3 mm; P = .001) and higher prevalence of antero-inferior cup prominence (5.7 versus 0.4%; P = .002). There was no significant difference in inclination, anteversion, and horizontal offset change between the two groups. In multivariate analyses, greater leg lengthening, prominent acetabular cup, women, and higher body mass index were associated with IPT. All patients reported improvement in groin pain after arthroscopic tenotomy, while 35.7% with nonoperative management reported improvement (P < .001).ConclusionsSymptomatic IPT occurred in 53 (3.3%) of the 1,602 primary THAs. Our findings suggest that leg lengthening as well as prominent acetabular cup in THAs can be associated with the development of IPT. Arthroscopic tenotomy was effective in relieving groin pain caused by IPT. |
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| Keywords: | iliopsoas tendinitis tendinosis groin pain leg lengthening total hip arthroplasty |
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