title: The painful hip: diagnosis and deliverance.
abstract: The differential diagnosis of the painful total   hip arthroplasty (resurfacing or total hip) includes infection,   failure of fixation (loosening), tendinitis, bursitis, synovitis,   adverse local tissue reaction (ALTR) to cobalt-chromium alloys,   and non-hip issues, such as spinal disorders, hernia, gynecologic,   and other pelvic pain. Assuming that the hip is the source of pain,   the first level question is prosthetic or non-prosthetic pain generator?   The second level prosthetic question is septic or aseptic? The third   level question (aseptic hips) is well-fixed or loose? ALTR is best   diagnosed by cross-sectional imaging. Successful treatment is dependent   on correct identification and elimination of the pain generator.   Treatment recommendations for ALTR and taper corrosion are evolving.
authors.affiliation: Joint Replacement Institute, St. Vincent Medical Center, 2200 W. Third Street, Suite 400, Los Angeles, California 90057, USA. schmalzried@earthlink.net
authors.forename: T P
authors.initials: TP
authors.lastname: Schmalzried
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation; D003937:Diagnosis, Differential; D006622:Hip Prosthesis / Q000009:adverse effects; D006801:Humans; D010149:Postoperative Pain / Q000209:etiology; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D011475:Prosthesis Failure; D016459:Prosthesis-Related Infections / Q000175:diagnosis / Q000628:therapy