title: Hip arthroscopy in patients with painful hip following resurfacing arthroplasty.
abstract: OBJECTIVE
  Determining the etiology of persistent groin pain after hip resurfacing arthroplasty (HRA) can be very challenging, even for the experienced surgeon. The purpose of the present study was to evaluate the use of hip arthroscopy as a diagnostic and therapeutic tool for the painful hip following resurfacing arthroplasty.
  
  
  METHODS
  In the present paper, the indications for arthroscopy and the arthroscopic findings in 15 patients with persistent and incapacitating groin pain following HRA are described. In all patients, nonsurgical diagnostic investigations such as ultrasound and radiography, blood sample analysis, and technetium and leukocyte-labeled scanning were inconclusive so that a definite diagnosis could not be established.
  
  
  RESULTS
  In seven patients, synovial biopsies were taken arthroscopically to rule out metal sensitivity, low-grade infection, or excessive metal wear. A definite diagnosis from histological evaluation could be made in 5 out of the 7 patients. Five patients were clinical suspicious of iliopsoas tendinitis. Diagnostic arthroscopy and histological analysis of the synovial samples provided an alternative diagnosis in 2 out of the 5 patients. Three patients underwent femoral osteoplasty for impingement due to reduced anterior femoral offset with subsequent symptom relief.
  
  
  CONCLUSIONS
  Hip arthroscopy after HRA is a valuable diagnostic alternative to open procedures in case of persistent groin pain, when noninvasive investigations fail to explain the symptoms. Multiple tissue samples should always be taken for histological examination and culture, as they are crucial in the final identification of the origin of the complaints.
authors.affiliation: Department of Orthopaedic Surgery and Traumatology, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium. christophe.pattyn@UGent.be
authors.forename: C
authors.initials: C
authors.lastname: Pattyn
authors.forename: R
authors.initials: R
authors.lastname: Verdonk
authors.forename: E
authors.initials: E
authors.lastname: Audenaert
mesh_terms: D000328:Adult; D000368:Aged; D018771:Arthralgia / Q000209:etiology / Q000601:surgery; D001178:Arthroplasty / Q000379:methods; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000379:methods; D001182:Arthroscopy / Q000379:methods*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis* / Q000601:surgery*; D020127:Recovery of Function; D012086:Reoperation / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome