Yeungnam Univ J Med.  2020 Jan;37(1):40-46. 10.12701/yujm.2019.00325.

Correlation between anterior thigh pain and morphometric mismatch of femoral stem

Affiliations
  • 1Department of Orthopaedic Surgery, Kosin University College of Medicine, Busan, Korea

Abstract

Background
Postoperative pain occurring after hip arthroplasty has become common since the expanded use of cementless femoral stems. The characteristic pain develop in the anterolateral thigh area. This study aimed to predict anterior thigh pain based on the measurements of postoperative anteroposterior (AP) and lateral (Lat) radiographs of the hip joint.
Methods
The present study included 26 patients (29 hips) who underwent total hip replacement or bipolar hemiarthroplasty between March 2010 and May 2016, whose complete clinical information was available. AP and Lat radiographs of the affected hip were taken on the day of surgery and 1 and 6 months postoperatively. Patients with improper radiographs were excluded. The distance from the femoral stem to the nearest cortical bone in the distal region of the stem was measured. The patient group with a visual analog scale (VAS) score of ≥6 points was designated as patients with anterior thigh pain.
Results
Sex, age, weight, height, body mass index, and bone mineral density in the lumbar spine and femur did not have a significant effect on postoperative VAS scores (p>0.05). Presence of contact between the femoral stem and cortical bone was associated with postoperative anterior thigh pain.
Conclusion
Hip AP and Lat radiographs are usually taken to confirm fixation and alignment of the femoral stem after hip arthroplasty. The measurement method introduced in this study can be utilized for predicting anterior thigh pain after hip arthroplasty.

Keyword

Hemiarthroplasty; Pain; Postoperative; Total hip replacement

Figure

  • Fig. 1. A 53-year-old male underwent artificial bipolar hip arthroplasty for femoral neck fracture (Garden Type IV). The patient complained of moderate anterior thigh pain starting from postoperative day 1. (A) Anteroposterior view. (B) Lateral view.


Reference

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