A positive hip arthrogram may predict lower function in patients with primary hip arthroplasty.
BACKGROUND
A local anesthetic hip arthrogram is a simple test mainly used as an adjunct to define the origin of hip pain. Temporary pain relief (a positive response) following an injection may lead to a surgeon recommending hip surgery. However, it is unclear whether relief of pain corresponds to better postoperative pain relief or function.


OBJECTIVE
We therefore compared the function in patients with a positive response to a local anesthetic hip arthrogram who underwent primary THA and patients with typical osteoarthritis presentation who underwent primary THA without a preoperative arthrogram.


METHODS
We retrospectively reviewed 22 patients who had a positive response to a local anesthetic hip arthrogram who subsequently underwent primary hip arthroplasty and a control group of 74 patients who had typical osteoarthritis hip pain and subsequent primary hip arthroplasty without having a previous arthrogram. All patients completed the Oxford Hip Score, WOMAC™ function short form, and the SF-12 preoperatively and at regular clinical followups. The minimum followups were 28 months (mean, 42 months; range, 28-72 months) for the study group and 33 months (mean, 52 months; range, 33-73 months) for the control group.


RESULTS
Patients in the arthrogram group had lower mean functional scores: 30 versus 39 for the Oxford Hip Score, 39 versus 46 for the WOMAC™, and 36 versus 42 for the physical component of the SF-12.


CONCLUSIONS
Preoperative use of a local anesthetic hip arthrogram remains an important tool to differentiate spinal disorders or confirm the hip as the cause of pain. However, patients who have a preoperative hip arthrogram to clarify symptoms may report a lower function score and pain relief than patients who do not.
Department of Orthopaedic Surgery, Singapore General Hospital, Outram Road, Singapore, 169608, Singapore. limbengteck85@yahoo.com.sg
Jason B T
JB
Lim
Lynne
L
Horey
Sanjeev
S
Patil
Robert M D
RM
Meek
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000779:Anesthetics, Local; D018771:Arthralgia / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D001175:Arthrography; D019644:Arthroplasty, Replacement, Hip; D001696:Biomechanical Phenomena; D016009:Chi-Square Distribution; D003937:Diagnosis, Differential; D004185:Disability Evaluation; D005260:Female; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery*; D010147:Pain Measurement; D011237:Predictive Value of Tests; D020127:Recovery of Function; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
D000779:Anesthetics, Local