Oversized cups as a major risk factor of postoperative pain after total hip arthroplasty.
After total hip arthroplasty (THA) some patients have persistent postoperative pain (POP). Some of these POP are anterior and are caused by an anterior iliopsoas impingement (AIPI). We have hypothesized that oversized implanted cups could be responsible for POP and especially AIPI. We screened 237 patients who had a primary THA and compared the size difference (ΔS) between the native femoral head and the implanted cup, in patients with and without POP. Median ΔS was 2 mm [-6; 11 mm] and patients with POP had a significantly increased ΔS (P < 0.0001). The threshold above which pain was significantly more frequent was ΔS ≥ 6 mm. Odds ratio was 14.4 for POP and 26 for AIPI pain when ΔS ≥ 6 mm.
Clinique Chirurgicale Orthopédique et Traumatologique, CHU Hôtel Dieu, Nantes, France.
Guillaume A
GA
Odri
Clinique Chirurgicale Orthopédique et Traumatologique, CHU Hôtel Dieu, Nantes, France.
Giovany B
GB
Padiolleau
Clinique Chirurgicale Orthopédique et Traumatologique, CHU Hôtel Dieu, Nantes, France.
François T
FT
Gouin
D000077:Acetabulum / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects; D017760:Bone Malalignment / Q000209:etiology; D005260:Female; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000601:surgery*; D010149:Postoperative Pain / Q000209:etiology*; D011475:Prosthesis Failure; D012307:Risk Factors
acetabular anteversion; acetabular inclination; anterior iliopsoas impingement; oversized cups; postoperative pain; total hip replacement