Skip to main content
SpringerLink
Log in

Pain distribution and response to total hip arthroplasty: a prospective observational study in 113 patients with end-stage hip disease

  • Original Article
  • Published:
Journal of Orthopaedic Science

Abstract

Purpose

The aim of this study was to investigate the pain patterns in patients with end-stage hip disease and to assess the response after total hip arthroplasty (THA).

Methods

The pain patterns of patients undergoing THA for end-stage hip diseases were prospectively evaluated by requesting them to mark a map of body areas before and after surgery. Patients were excluded if they had coexisting pathology of the knee or spine. The pain measurements were quantified using visual analog scales, and factors that may contribute to different pain patterns were also evaluated.

Results

Among 113 patients (113 hips) enrolled in the study, the groin, anterior thigh, buttock, anterior knee, and greater trochanter were the most common pain locations before THA. Pain over the lower back, shin, and calf areas, which were not generally considered referral pain areas from hip diseases, was present in 21.2, 7.1, and 2.7% patients, respectively. The presence of lower back pain (LBP) was statistically more common in patients with longer duration of hip symptoms. Regardless of the different pain patterns, 97.3% (110 of 113) of patients reported complete pain relief within 12 weeks after THA.

Conclusions

The distribution of pain from end-stage hip diseases is versatile, and presence of pain in areas other than around the hip is not uncommon. LBP was more common in patients with longer duration of symptoms. THA satisfactorily resolves the pain in all areas soon after surgery.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Callaghan JJ, Templeton JE, Liu SS, Pedersen DR, Goetz DD, Sullivan PM, Johnston RC. Results of Charnley total hip arthroplasty at a minimum of thirty years. A concise follow-up of a previous report. J Bone Joint Surg Am. 2004;86:690–5.

    PubMed  Google Scholar 

  2. Hodges DL, McGuire TJ, Kumar VN. Diagnosis of hip pain, an anatomic approach. Orthop Rev. 1987;16:109–13.

    PubMed  CAS  Google Scholar 

  3. Flatman JG. Hip diseases with referred pain to the knee. JAMA. 1975;234:967–8.

    Article  PubMed  CAS  Google Scholar 

  4. Lesher JM, Dreyfuss P, Hager N, Kaplan M, Furman M. Hip joint pain referral patterns: a descriptive study. Pain Med. 2008;9:22–5.

    Article  PubMed  Google Scholar 

  5. van Saase JL, van Romunde LK, Cats A, Vandenbroucke JP, Valkenburg HA. Epidemiology of osteoarthritis: Zoetermeer survey. Comparison of radiological osteoarthritis in a Dutch population with that in 10 other populations. Ann Rheum Dis. 1989;48:271–80.

    Article  PubMed  Google Scholar 

  6. Ben-Galim P, Ben-Galim T, Rand N, Haim A, Hipp J, Dekel S, Floman Y. Hip-spine syndrome: the effect of total hip replacement surgery on low back pain in severe osteoarthritis of the hip. Spine (Phila Pa 1976). 2007;32:2099–102.

    Article  Google Scholar 

  7. Khan NQ, Woolson ST. Referral patterns of hip pain in patients undergoing total hip replacement. Orthopedics. 1998;21:123–6.

    PubMed  CAS  Google Scholar 

  8. Khan AM, McLoughlin E, Giannakas K, Hutchinson C, Andrew JG. Hip osteoarthritis: where is the pain? Ann R Coll Surg Engl. 2004;86:119–21.

    Article  PubMed  CAS  Google Scholar 

  9. Gannon JM, Gustilo RB. Treat the hip and not the knee: a report of four cases. Orthopedics. 1992;15:474–7.

    PubMed  CAS  Google Scholar 

Download references

Acknowledgment

The authors would like to thank Dr. Chee Jen Chang (Chang Gung University, Taoyuan, Taiwan) for his assistance with the statistical analysis.

Conflict of interest

Each author certifies that he has no commercial associations (e.g, stock ownership, equity interest, patent/licensing arrangements) that could pose a conflict of interest in connection with the submitted article. Each author certifies that his institution has approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent was obtained.

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Chang Gung University, 5, Fu-Hsin St., Kweishan, Taoyuan, Taiwan, ROC

    Pang-Hsin Hsieh, Yuhan Chang, Dave W. Chen, Mel S. Lee, Hsin-Nung Shih & Steve W. N. Ueng

  2. College of Medicine, Chang Gung University, Taoyuan, Taiwan

    Pang-Hsin Hsieh, Yuhan Chang, Dave W. Chen, Mel S. Lee, Hsin-Nung Shih & Steve W. N. Ueng

Authors
  1. Pang-Hsin Hsieh
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yuhan Chang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Dave W. Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mel S. Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hsin-Nung Shih
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Steve W. N. Ueng
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yuhan Chang.

Additional information

P.-H. Hsieh and Y. Chang contributed equally to this work.

About this article

Cite this article

Hsieh, PH., Chang, Y., Chen, D.W. et al. Pain distribution and response to total hip arthroplasty: a prospective observational study in 113 patients with end-stage hip disease. J Orthop Sci 17, 213–218 (2012). https://doi.org/10.1007/s00776-012-0204-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00776-012-0204-1

Keywords

Search

Navigation