| Subject: |
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Hip replacement - still having groin pain |
| Name: |
|
Debbie |
| Date Posted: |
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Oct 5, 06 - 3:18 PM |
| Email: |
|
dka0127@yahoo.com |
| Message: |
|
At 48 I had two THR and have done wonderfully, but my older brother has
had a horrible experience. I had both of my legs lengthened. We have a
family history of degenerative bone disorder. He was born club-footed
and had several surgeries in his early childhood just to walk. Because
of his history he had one leg shorter than the other so he too had his
leg lengthened. When he still could not walk he came to Houston to have
my surgeon re-do his hip, but still, one year later has groin pain and
is on a cane.
I have surfed the net to find out what could possibly be the problem.
My brother has also had lower back (spine) problems off and on his whole
life. I finally found some information that may be of help to others
out there. PLEASE POST THIS INFORMATION!
Thank you,
Debbie in Houston
#1.
Lumbar spine disease (low back)
When is the lumbar spine the source of pain?
Before the total joint surgery
The presence of a limp, groin pain, and / or limited internal rotation
of the hip predicts that the pain is originating primarily from the hip
joint disease, as opposed to originating from the spine.
Patients with a limp were seven times more likely to have their leg
pain originating from the hip disorder than from the spine disorder
alone. Similarly, patients with groin pain and limited internal rotation
of the hips were 14 times more likely to have their leg pain originating
from the hip disorder than from the spine disorder alone.
The spine suffers when the hip joint is diseased; the stiff diseased
hip joint transfers the loads to the lumbar spine that wears out.
These patients may have pain radiating in the buttock and thigh that
may be confused with hip pain, especially if the X-ray pictures also
show small changes in the hip joint.
Patients with pain radiating in the leg should always be examined with
X-ray pictures of the lumbar spine and possibly other examinations of
the lumbar spine (MRI) to exclude lumbar spine disease as a cause of
the pain before one decides on total hip operation. Pain caused by hip
joint disease does not radiate below the knee joint area.
Patients with pain caused by the damaged hip joint usually have
painfully limited movements in the hip joint.
More seldom, however, both causes of leg pain, osteoarthritis of the
hip and lumbar spine disease, may be coexistent in one patient. In rare
cases, both diseases may be treated by operation. The surgeon then faces
the difficult decision which of them, the hip or the spine, should be
operated on first.
#2.
Groin pain following total hip arthroplasty raises the concern of
prosthetic loosening, especially of the acetabular component. Evidence
of such hip pathology must be vigorously sought or else revision surgery
may be performed unnecessarily, with no resolution of the symptoms.
We report the occurrence of gluteal artery stenosis in a patient who
had recently undergone a hip replacement. To our knowledge, this rare
condition has not been described as a cause of groin pain in such a
patient. Gluteal artery insufficiency, along with the differential
diagnosis of groin pain following total hip arthroplasty, is discussed. |
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