Subscribe to RSS
Please copy the URL and add it into your RSS Feed Reader.
https://www.thieme-connect.de/rss/thieme/en/10.1055-s-00031934.xml
The Journal of Hip Surgery 2018; 02(02): 097-108
DOI: 10.1055/s-0038-1667033
DOI: 10.1055/s-0038-1667033
Original Article
Evaluation of the Painful Total Hip Arthroplasty
Further Information
Publication History
23 December 2017
29 May 2018
Publication Date:
12 July 2018 (online)
![](https://www.thieme-connect.de/media/10.1055-s-00031934/201802/lookinside/thumbnails/10-1055-s-0038-1667033_170033oa-1.jpg)
Abstract
The total hip arthroplasty (THA) remains as one of the most successful procedures improving function and quality of life. However, despite its success, failures do occur. The workup of a painful THA should be methodical, prioritizing the most likely to least likely etiologies. Intrinsic and extrinsic sources of pain must be evaluated from data collected through an accurate history, detailed physical examination, laboratory analysis, and imaging interpretation.
-
References
- 1 Mancuso CA, Salvati EA, Johanson NA, Peterson MG, Charlson ME. Patients' expectations and satisfaction with total hip arthroplasty. J Arthroplasty 1997; 12 (04) 387-396
- 2 Bashinskaya B, Zimmerman RM, Walcott BP, Antoci V. Arthroplasty utilization in the United States is predicted by age-specific population groups. ISRN Orthop 2012; 2012 (12) 1-8
- 3 Wylde V, Hewlett S, Learmonth ID, Dieppe P. Persistent pain after joint replacement: prevalence, sensory qualities, and postoperative determinants. Pain 2011; 152 (03) 566-572
- 4 Singh JA, Lewallen D. Predictors of pain and use of pain medications following primary Total Hip Arthroplasty (THA): 5,707 THAs at 2-years and 3,289 THAs at 5-years. BMC Musculoskelet Disord 2010; 11 (01) 90
- 5 Tilbury C, Haanstra TM, Leichtenberg CS. , et al. Unfulfilled expectations after total hip and knee arthroplasty surgery: there is a need for better preoperative patient information and education. J Arthroplasty 2016; 31 (10) 2139-2145
- 6 Goesling J, Moser SE, Zaidi B. , et al. Trends and predictors of opioid use after total knee and total hip arthroplasty. Pain 2016; 157 (06) 1259-1265
- 7 Robbins GM, Masri BA, Garbuz DS, Duncan CP. Evaluation of pain in patients with apparently solidly fixed total hip arthroplasty components. J Am Acad Orthop Surg 2002; 10 (02) 86-94
- 8 Lanting BA, MacDonald SJ. The painful total hip replacement: diagnosis and deliverance. Bone Joint J 2013; 95-B :(11, Suppl A) 70-73
- 9 Buckland AJ, Miyamoto R, Patel RD, Slover J, Razi AE. Differentiating hip pathology from lumbar spine pathology: key points of evaluation and management. J Am Acad Orthop Surg 2017; 25 (02) e23-e34
- 10 Röder C, Vogel R, Burri L, Dietrich D, Staub LP. Total hip arthroplasty: leg length inequality impairs functional outcomes and patient satisfaction. BMC Musculoskelet Disord 2012; 13 (01) 95
- 11 Smith G, Train J, Mitty H, Jacobson J. Hip pain caused by buttock claudication. Relief of symptoms by transluminal angioplasty. Clin Orthop Relat Res 1992; (284) 176-180
- 12 Gwam CU, Mistry JB, Mohamed NS. , et al. Current epidemiology of revision total hip arthroplasty in the United States: national inpatient sample 2009 to 2013. J Arthroplasty 2017; 32 (07) 2088-2092
- 13 Buckland AJ, Puvanesarajah V, Vigdorchik J. , et al. Dislocation of a primary total hip arthroplasty is more common in patients with a lumbar spinal fusion. Bone Joint J 2017; 99-B (05) 585-591
- 14 Sing DC, Barry JJ, Aguilar TU. , et al. Prior Lumbar Spinal Arthrodesis Increases Risk of Prosthetic-Related Complication in Total Hip Arthroplasty. J Arthroplasty 2016; 31 (9, Suppl): 227-232.e1
- 15 Barry JJ, Sing DC, Vail TP, Hansen EN. Early outcomes of primary total hip arthroplasty after prior lumbar spinal fusion. J Arthroplasty 2017; 32 (02) 470-474
- 16 Wetters NG, Murray TG, Moric M, Sporer SM, Paprosky WG, Della Valle CJ. Risk factors for dislocation after revision total hip arthroplasty. Clin Orthop Relat Res 2013; 471 (02) 410-416
- 17 Lewinnek GE, Lewis JL, Tarr R, Compere CL, Zimmerman JR. Dislocations after total hip-replacement arthroplasties. J Bone Joint Surg Am 1978; 60 (02) 217-220
- 18 Abdel MP, von Roth P, Jennings MT, Hanssen AD, Pagnano MW. What safe zone? The vast majority of dislocated thas are within the Lewinnek safe zone for acetabular component position. Clin Orthop Relat Res 2016; 474 (02) 386-391
- 19 Ranawat C, Maynard M. Modern techniques of cemented total hip arthroplasty. Tech Orthop 1991; (06) 17-25
- 20 Kobayashi A, Donnelly WJ, Scott G, Freeman MA. Early radiological observations may predict the long-term survival of femoral hip prostheses. J Bone Joint Surg Br 1997; 79 (04) 583-589
- 21 Udomkiat P, Wan Z, Dorr LD. Comparison of preoperative radiographs and intraoperative findings of fixation of hemispheric porous-coated sockets. J Bone Joint Surg Am 2001; 83-A (12) 1865-1870
- 22 DeLee JG, Charnley J. Radiological demarcation of cemented sockets in total hip replacement. Clin Orthop Relat Res 1976; (121) 20-32
- 23 Hodgkinson JP, Shelley P, Wroblewski BM. The correlation between the roentgenographic appearance and operative findings at the bone-cement junction of the socket in Charnley low friction arthroplasties. Clin Orthop Relat Res 1988; (228) 105-109
- 24 Gruen TA, McNeice GM, Amstutz HC. “Modes of failure” of cemented stem-type femoral components: a radiographic analysis of loosening. Clin Orthop Relat Res 1979; (141) 17-27
- 25 Harris WH, McCarthy Jr JC, O'Neill DA. Femoral component loosening using contemporary techniques of femoral cement fixation. J Bone Joint Surg Am 1982; 64 (07) 1063-1067
- 26 Engh CA, Bobyn JD, Glassman AH. Porous-coated hip replacement. The factors governing bone ingrowth, stress shielding, and clinical results. J Bone Joint Surg Br 1987; 69 (01) 45-55
- 27 Palestro CJ. Nuclear medicine and the failed joint replacement: Past, present, and future. World J Radiol 2014; 6 (07) 446-458
- 28 Aliabadi P, Tumeh SS, Weissman BN, McNeil BJ. Cemented total hip prosthesis: radiographic and scintigraphic evaluation. Radiology 1989; 173 (01) 203-206
- 29 Utz JA, Lull RJ, Galvin EG. Asymptomatic total hip prosthesis: natural history determined using Tc-99m MDP bone scans. Radiology 1986; 161 (02) 509-512
- 30 Oswald SG, Van Nostrand D, Savory CG, Anderson JH, Callaghan JJ. The acetabulum: a prospective study of three-phase bone and indium white blood cell scintigraphy following porous-coated hip arthroplasty. J Nucl Med 1990; 31 (03) 274-280
- 31 Oswald SG, Van Nostrand D, Savory CG, Callaghan JJ. Three-phase bone scan and indium white blood cell scintigraphy following porous coated hip arthroplasty: a prospective study of the prosthetic tip. J Nucl Med 1989; 30 (08) 1321-1331
- 32 Wukich DK, Abreu SH, Callaghan JJ. , et al. Diagnosis of infection by preoperative scintigraphy with indium-labeled white blood cells. J Bone Joint Surg Am 1987; 69 (09) 1353-1360
- 33 Verberne SJ, Raijmakers PG, Temmerman OPP. The accuracy of imaging techniques in the assessment of periprosthetic hip infection: a systematic review and meta-analysis. J Bone Joint Surg Am 2016; 98 (19) 1638-1645
- 34 Jafari SM, Coyle C, Mortazavi SMJ, Sharkey PF, Parvizi J. Revision hip arthroplasty: infection is the most common cause of failure. Clin Orthop Relat Res 2010; 468 (08) 2046-2051
- 35 Zmistowski B, Karam JA, Durinka JB, Casper DS, Parvizi J. Periprosthetic joint infection increases the risk of one-year mortality. J Bone Joint Surg Am 2013; 95 (24) 2177-2184
- 36 Parvizi J, Zmistowski B, Berbari EF. , et al. New definition for periprosthetic joint infection: from the Workgroup of the Musculoskeletal Infection Society. Clin Orthop Relat Res 2011; 469 (11) 2992-2994
- 37 Cats-Baril W, Gehrke T, Huff K, Kendoff D, Maltenfort M, Parvizi J. International consensus on periprosthetic joint infection: description of the consensus process. Clin Orthop Relat Res 2013; 471 (12) 4065-4075
- 38 Zmistowski B, Della Valle C, Bauer TW. , et al. Diagnosis of periprosthetic joint infection. J Orthop Res 2014; 32 (Suppl. 01) S98-S107
- 39 Berbari E, Mabry T, Tsaras G. , et al. Inflammatory blood laboratory levels as markers of prosthetic joint infection: a systematic review and meta-analysis. J Bone Joint Surg Am 2010; 92 (11) 2102-2109
- 40 Cipriano CA, Brown NM, Michael AM, Moric M, Sporer SM, Della Valle CJ. Serum and synovial fluid analysis for diagnosing chronic periprosthetic infection in patients with inflammatory arthritis. J Bone Joint Surg Am 2012; 94 (07) 594-600
- 41 Yi PH, Cross MB, Moric M, Sporer SM, Berger RA, Della Valle CJ. The 2013 Frank Stinchfield Award: diagnosis of infection in the early postoperative period after total hip arthroplasty. Clin Orthop Relat Res 2014; 472 (02) 424-429
- 42 Parr AM, Zoutman DE, Davidson JS. Antimicrobial activity of lidocaine against bacteria associated with nosocomial wound infection. Ann Plast Surg 1999; 43 (03) 239-245
- 43 Stratford AF, Zoutman DE, Davidson JSD. Effect of lidocaine and epinephrine on Staphylococcus aureus in a guinea pig model of surgical wound infection. Plast Reconstr Surg 2002; 110 (05) 1275-1279
- 44 Tsaras G, Maduka-Ezeh A, Inwards CY. , et al. Utility of intraoperative frozen section histopathology in the diagnosis of periprosthetic joint infection: a systematic review and meta-analysis. J Bone Joint Surg Am 2012; 94 (18) 1700-1711
- 45 Choi H-R, Kwon Y-M, Freiberg AA, Nelson SB, Malchau H. Periprosthetic joint infection with negative culture results: clinical characteristics and treatment outcome. J Arthroplasty 2013; 28 (06) 899-903
- 46 Shahi A, Deirmengian C, Higuera C. , et al. Premature therapeutic antimicrobial treatments can compromise the diagnosis of late periprosthetic joint infection. Clin Orthop Relat Res 2015; 473 (07) 2244-2249
- 47 Schäfer P, Fink B, Sandow D, Margull A, Berger I, Frommelt L. Prolonged bacterial culture to identify late periprosthetic joint infection: a promising strategy. Clin Infect Dis 2008; 47 (11) 1403-1409
- 48 Diaz-Ledezma C, Lamberton C, Lichstein P, Parvizi J. Diagnosis of periprosthetic joint infection: the role of nuclear medicine may be overestimated. J Arthroplasty 2015; 30 (06) 1044-1049
- 49 Ganz T, Selsted ME, Szklarek D. , et al. Defensins. Natural peptide antibiotics of human neutrophils. J Clin Invest 1985; 76 (04) 1427-1435
- 50 Deirmengian C, Kardos K, Kilmartin P, Cameron A, Schiller K, Parvizi J. Diagnosing periprosthetic joint infection: has the era of the biomarker arrived?. Clin Orthop Relat Res 2014; 472 (11) 3254-3262
- 51 Deirmengian C, Kardos K, Kilmartin P. , et al. The alpha-defensin test for periprosthetic joint infection outperforms the leukocyte esterase test strip. Clin Orthop Relat Res 2015; 473 (01) 198-203
- 52 Deirmengian C, Kardos K, Kilmartin P, Gulati S, Citrano P, Booth Jr RE. The alpha-defensin test for periprosthetic joint infection responds to a wide spectrum of organisms. Clin Orthop Relat Res 2015; 473 (07) 2229-2235
- 53 Bonanzinga T, Zahar A, Dütsch M, Lausmann C, Kendoff D, Gehrke T. How reliable is the alpha-defensin immunoassay test for diagnosing periprosthetic joint infection? A prospective study. Clin Orthop Relat Res 2017; 475 (02) 408-415
- 54 Yuan J, Yan Y, Zhang J, Wang B, Feng J. Diagnostic accuracy of alpha-defensin in periprosthetic joint infection: a systematic review and meta-analysis. Int Orthop 2017; 41 (12) 2447-2455
- 55 Chalmers BP, Sculco PK, Sierra RJ, Trousdale RT, Berry DJ. iliopsoas impingement after primary total hip arthroplasty: operative and nonoperative treatment outcomes. J Bone Joint Surg Am 2017; 99 (07) 557-564
- 56 Abdel MP, Cottino U, Mabry TM. Management of periprosthetic femoral fractures following total hip arthroplasty: a review. Int Orthop 2015; 39 (10) 2005-2010
- 57 Duncan CP, Masri BA. Fractures of the femur after hip replacement. Instr Course Lect 1995; 44: 293-304
- 58 Huiskes R. The various stress patterns of press-fit, ingrown, and cemented femoral stems. Clin Orthop Relat Res 1990; (261) 27-38
- 59 Huiskes R, Weinans H, van Rietbergen B. The relationship between stress shielding and bone resorption around total hip stems and the effects of flexible materials. Clin Orthop Relat Res 1992; (274) 124-134
- 60 Head WC, Bauk DJ, Emerson Jr RH. Titanium as the material of choice for cementless femoral components in total hip arthroplasty. Clin Orthop Relat Res 1995; (311) 85-90
- 61 Harris WH. Osteolysis and particle disease in hip replacement. A review. Acta Orthop Scand 1994; 65 (01) 113-123
- 62 Gallo J, Goodman SB, Konttinen YT, Raska M. Particle disease: biologic mechanisms of periprosthetic osteolysis in total hip arthroplasty. Innate Immun 2013; 19 (02) 213-224
- 63 Konttinen YT, Zhao D, Beklen A. , et al. The microenvironment around total hip replacement prostheses. Clin Orthop Relat Res 2005; (430) 28-38
- 64 Ren P-G, Irani A, Huang Z, Ma T, Biswal S, Goodman SB. Continuous infusion of UHMWPE particles induces increased bone macrophages and osteolysis. Clin Orthop Relat Res 2011; 469 (01) 113-122
- 65 Aspenberg P, van der Vis H. Fluid pressure may cause periprosthetic osteolysis. Particles are not the only thing. Acta Orthop Scand 1998; 69 (01) 1-4
- 66 Dumbleton JH, Manley MT, Edidin AA. A literature review of the association between wear rate and osteolysis in total hip arthroplasty. J Arthroplasty 2002; 17 (05) 649-661
- 67 Bedard NA, Burnett RA, DeMik DE, Gao Y, Liu SS, Callaghan JJ. Are trends in total hip arthroplasty bearing surface continuing to change? 2007-2015 usage in a large database cohort. J Arthroplasty 2017; 32 (12) 3777-3781
- 68 Sukur E, Akman YE, Ozturkmen Y, Kucukdurmaz F. Particle Disease: A Current Review of the Biological Mechanisms in Periprosthetic Osteolysis After Hip Arthroplasty. Open Orthop J 2016; 10: 241-251
- 69 Cooper HJ, Della Valle CJ, Berger RA. , et al. Corrosion at the head-neck taper as a cause for adverse local tissue reactions after total hip arthroplasty. J Bone Joint Surg Am 2012; 94 (18) 1655-1661
- 70 Nawabi DH, Do HT, Ruel A. , et al. Comprehensive Analysis of a Recalled Modular Total Hip System and Recommendations for Management. J Bone Joint Surg Am 2016; 98 (01) 40-47
- 71 Elmallah RK, Cherian JJ, Meneghini RM, Hozack WJ, Westrich GH, Mont MA. How to Approach a Recalled Dual Modular Hip Implant: An Update. J Arthroplasty 2016; 31 (11) 2646-2652
- 72 Kwon Y-M, Lombardi AV, Jacobs JJ, Fehring TK, Lewis CG, Cabanela ME. Risk stratification algorithm for management of patients with metal-on-metal hip arthroplasty: consensus statement of the American Association of Hip and Knee Surgeons, the American Academy of Orthopaedic Surgeons, and the Hip Society. J Bone Joint Surg Am 2014; 96 (01) e4
- 73 Kwon Y-M, Fehring TK, Lombardi AV, Barnes CL, Cabanela ME, Jacobs JJ. Risk stratification algorithm for management of patients with dual modular taper total hip arthroplasty: consensus statement of the American Association of Hip and Knee Surgeons, the American Academy of Orthopaedic Surgeons and the Hip Society. J Arthroplasty 2014; 29 (11) 2060-2064
- 74 Guenther D, Thomas P, Kendoff D, Omar M, Gehrke T, Haasper C. Allergic reactions in arthroplasty: myth or serious problem?. Int Orthop 2016; 40 (02) 239-244
- 75 Thyssen JP, Jakobsen SS, Engkilde K, Johansen JD, Søballe K, Menné T. The association between metal allergy, total hip arthroplasty, and revision. Acta Orthop 2009; 80 (06) 646-652
- 76 Münch HJ, Jacobsen SS, Olesen JT. , et al. The association between metal allergy, total knee arthroplasty, and revision: study based on the Danish Knee Arthroplasty Register. Acta Orthop 2015; 86 (03) 378-383
- 77 Caicedo MS, Solver E, Coleman L, Jacobs JJ, Hallab NJ. Females with unexplained joint pain following total joint arthroplasty exhibit a higher rate and severity of hypersensitivity to implant metals compared with males: implications of sex-based bioreactivity differences. J Bone Joint Surg Am 2017; 99 (08) 621-628
- 78 Nam D, Li K, Riegler V, Barrack RL. Patient-reported metal allergy: a risk factor for poor outcomes after total joint arthroplasty?. J Arthroplasty 2016; 31 (09) 1910-1915
- 79 Balach T, Baldwin PC, Intravia J. Atypical femur fractures associated with diphosphonate use. J Am Acad Orthop Surg 2015; 23 (09) 550-557
- 80 Zhu Y, Zhang F, Chen W, Zhang Q, Liu S, Zhang Y. Incidence and risk factors for heterotopic ossification after total hip arthroplasty: a meta-analysis. Arch Orthop Trauma Surg 2015; 135 (09) 1307-1314
- 81 Brooker AF, Bowerman JW, Robinson RA, Riley Jr LH. Ectopic ossification following total hip replacement. Incidence and a method of classification. J Bone Joint Surg Am 1973; 55 (08) 1629-1632
- 82 Vasileiadis GI, Amanatullah DF, Crenshaw JR, Taunton MJ, Kaufman KR. Effect of heterotopic ossification on hip range of motion and clinical outcome. J Arthroplasty 2015; 30 (03) 461-464
- 83 Shubert D, Madoff S, Milillo R, Nandi S. Neurovascular structure proximity to acetabular retractors in total hip arthroplasty. J Arthroplasty 2015; 30 (01) 145-148