The role of arthroscopy in the treatment of groin pain after total hip arthroplasty: Our experience

Mattia Filanti, Chiara Carubbi, Nicolandrea Del Piccolo, Nicola Rani, Alessandro Mazzotta, Dante Dallari

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Aim: The purpose of the study was to present our arthroscopic surgical technique and the results in patient with pain after a hip replacement. Methods: Between November 2009 and September 2011, 35 patients with groin pain after total hip arthroplasty (THA) were treated arthroscopically. The patients underwent a preoperative examination consisting in careful history, physical examination, laboratory evaluation, diagnostic evaluation using x-rays and pelvis CT scans. In patients for whom the clinical picture suggested iliopsoas tendonitis, we also performed injection of local anaesthetic on the iliopsoas tendon sheath. All the patients were positioned in the supine decubitus position with traction applied, using 2 arthroscopic portals (AL, MID-A). An extensive debridement of adhesions, periprosthetic tissue and neocapsula were performed; when there were signs of iliopsoas impingement, a transcapsular tenotomy was performed according to Wettstein technique. Results: The average age was 57 (29-77) years old. The average time to onset of symptoms was 10.8 (5-15) months after THA. The average preoperative Harris Hip Score (HHS) was 44.1 (range 32-56). The average preoperative Medical Research Council (MRC) scale for muscle strenght was 3.27 (range 3-4). After 24 months of follow-up patients show an average HHS of 75.73 (range 50-91). Patients who underwent iliopsoas release show a postoperative HHS of 83.28 (range 61-91). The average postoperative MRC scale was 4. 45. Conclusions: Hip arthroscopy in treatment of reactive synovitis and adhesions shows good results according to literature. Hip arthroscopy in treatment of anterior iliopsoas impingement is the most useful instrument, being less invasive than the classic open technique.

Original languageEnglish
Pages (from-to)S28-S33
Number of pages6
JournalHIP International
Volume26
DOIs
Publication statusPublished - May 1 2016

Fingerprint

Groin
Arthroscopy
Arthroplasty
Hip
Pain
Therapeutics
Biomedical Research
Tissue Adhesions
Tenotomy
Tendinopathy
Synovitis
Supine Position
Traction
Debridement
Local Anesthetics
Pelvis
Tendons
Physical Examination
History
X-Rays

Keywords

  • Arthroscopic tenotomy
  • Groin pain
  • Ileopsoas tendinitis
  • Total hip arthroplasty

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Surgery

Cite this

The role of arthroscopy in the treatment of groin pain after total hip arthroplasty : Our experience. / Filanti, Mattia; Carubbi, Chiara; Del Piccolo, Nicolandrea; Rani, Nicola; Mazzotta, Alessandro; Dallari, Dante.

In: HIP International, Vol. 26, 01.05.2016, p. S28-S33.

Research output: Contribution to journalArticle

Filanti, Mattia ; Carubbi, Chiara ; Del Piccolo, Nicolandrea ; Rani, Nicola ; Mazzotta, Alessandro ; Dallari, Dante. / The role of arthroscopy in the treatment of groin pain after total hip arthroplasty : Our experience. In: HIP International. 2016 ; Vol. 26. pp. S28-S33.
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abstract = "Aim: The purpose of the study was to present our arthroscopic surgical technique and the results in patient with pain after a hip replacement. Methods: Between November 2009 and September 2011, 35 patients with groin pain after total hip arthroplasty (THA) were treated arthroscopically. The patients underwent a preoperative examination consisting in careful history, physical examination, laboratory evaluation, diagnostic evaluation using x-rays and pelvis CT scans. In patients for whom the clinical picture suggested iliopsoas tendonitis, we also performed injection of local anaesthetic on the iliopsoas tendon sheath. All the patients were positioned in the supine decubitus position with traction applied, using 2 arthroscopic portals (AL, MID-A). An extensive debridement of adhesions, periprosthetic tissue and neocapsula were performed; when there were signs of iliopsoas impingement, a transcapsular tenotomy was performed according to Wettstein technique. Results: The average age was 57 (29-77) years old. The average time to onset of symptoms was 10.8 (5-15) months after THA. The average preoperative Harris Hip Score (HHS) was 44.1 (range 32-56). The average preoperative Medical Research Council (MRC) scale for muscle strenght was 3.27 (range 3-4). After 24 months of follow-up patients show an average HHS of 75.73 (range 50-91). Patients who underwent iliopsoas release show a postoperative HHS of 83.28 (range 61-91). The average postoperative MRC scale was 4. 45. Conclusions: Hip arthroscopy in treatment of reactive synovitis and adhesions shows good results according to literature. Hip arthroscopy in treatment of anterior iliopsoas impingement is the most useful instrument, being less invasive than the classic open technique.",
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