Aims and objectives
We aim to investigate the relationship between radiographic measurements of femoral offset,
global offset,
abductor lever arm and trochanteric impingement distance with sonographic evidence of gluteal tendinopathy and trochanteric bursitis in patients with lateral hip pain both in a native hip and post total hip arthroplasty (THA).
Based on previous studies1-5,
we hypothesised that alteration in trochanteric impingement distance,
abductor lever arm,
femoral and global offset would be associated with gluteal tendinopathy and trochanteric bursitis.
We also sought to describe the normal range of these...
Methods and materials
Patients with lateral hip pain referred for ultrasound of the hip at our institution between February 2012 and October 2017 were identified using our institutions radiology management system.
Patients referred with lateral hip pain in both a native hip and post THA were included in the study.
Patients with sonographic evidence of subgluteal bursitis,
trochanteric bursitis and gluteal tendinopathy as well those with clinical evidence of trochanteric bursitis whom underwent ultrasound-guided diagnostic injection were included in the study.
Patient demographics were recorded for all patients....
Results
We retrospectively reviewed 409 ultrasound studies performed on 384 patients referred with lateral hip pain in both a native hip and post THA.
One-hundred and eleven patients were excluded including patients with bilateral symptoms,
bilateral THR and patients with imaging unavailable for review.
A total of 273 patients were therefore included in the study.
Mean age was 59.7 years (range 14-96,
SD 15.0) and there was a female (n = 211,
77.3%) predominance.
One hundred and seven (39.2%) patients had a THA.
Findings on ultrasound...
Conclusion
Pain post THA occurs in a small percentage of patients.
Lateral hip pain is reported to occur in approximately 4.4% of patients following THA6 and can be attributed to a variety of causes including gluteal tendinopathy,
trochanteric bursitis and trochanteric pelvic impingement.
When performing THA,
the femoral stem and acetabular cup must be positioned optimally to restore mechanical forces and range of motion.
It has been shown that hip abductor function is optimised by a slight increase in femoral offset and inferomedial cup position to...
Personal information
Jennifer Murphy
Royal Orthopaedic Hospital NHS Foundation Trust
Bristol Road South
Northfield
Birmingham
B31 2AP
Email:
[email protected]
References
1.
Asayama I,
Chamnongkich S,
Simpson KJ,
et al.
Reconstructed hip joint position and abductor muscle strength after total hip arthroplasty.
J Arthroplasty.
2005 Jun; 20(4):414-20.
2.
Dastane M,
Dorr LD,
Tarwala R,
et al.
Hip offset in total hip arthroplasty: quantitative measurement with navigation.
Clin Orthop Relat Res 2010; 469(2):429–436.
3.
Delp SL,
Wixson RL,
Komattu AV,
et al.
How superior placement of the joint center in hip arthroplasty affects the abductor muscles.Clin Orthop Relat Res.1996;328:137–146.
4.
Macfarlane RJ,
Hadi S,
Binns M.
Trochanteric...