Groin Pain after Metal on Metal Hip Resurfacing: Mid-Term Follow-Up of a Prospective Cohort of Patients
Background and Purpose:
Groin pain after metal on metal hip resurfacing has been previously reported. The purpose of this study was to determine the natural history of a cohort of patients with groin pain after hip resurfacing previously reported on and incidence of revision surgery.
Our group previously reported an 18% incidence of groin pain at a mean of 18 months post hip resurfacing. This cohort of groin pain patients was prospectively followed. Patients were evaluated using a visual analog pain rating score, the University of California at Los Angeles (UCLA) Physical Activity Index, and the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) Index. Functional outcome scores were compared from initial to latest follow up using the paired Student’s t test. Further diagnostic evaluation and/or intervention or other complication was also recorded.
The latest mean follow up from surgery was 63 ± 15 months. The mean pain rating, UCLA, and WOMAC scores all improved at latest follow up, although WOMAC score improvement was not statistically significant. Mean pain rating score improved from 5.2 ± 2.0 to 2.5 ± 1.4 (p = 0.0001). UCLA activity score improved from 6.4 ± 2.0 to 6.9 ± 1.6 (p = 0.03). Total WOMAC score improved from 75.6 ± 20.5 to 84.5 ± 14.8 (p = 0.15). Only one patient was revised for an adverse local tissue reaction.
Groin pain post hip resurfacing has a multifactorial etiology, and in the vast majority of cases improves over time with no significant functional limitations. However, the surgeon should be aware of the many potential causes, and help minimize the possibility with proper patient selection and surgical technique.
Keywordsmetal-on-metal hip resurfacing groin pain
One or more of the authors (PEB and PRK) have received funding from Wright Medical Technology, in support of this research. One or more of the authors have received or may receive payments or benefits from a commercial entity that may be perceived as a potential conflict of interest. One or more of the authors’ institution have received or may receive payments or benefits from a commercial entity that may be perceived as a potential conflict of interest.
Each author certifies that his or her institution has approval for the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.
This work was performed at the Ottawa General Hospital (Division of Orthopaedic Surgery, University of Ottawa), Ottawa, Ontario, Canada.
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