Elsevier

The Journal of Arthroplasty

Volume 25, Issue 4, June 2010, Pages 659.e5-659.e8
The Journal of Arthroplasty

Case Report
Iliopsoas Tendonitis due to the Protrusion of an Acetabular Component Fixation Screw After Total Hip Arthroplasty

https://doi.org/10.1016/j.arth.2009.02.019Get rights and content

Abstract

Postoperative pain after total hip arthroplasty can have a wide range of underlying causes. Iliopsoas tendonitis secondary to the impingement of this tendon is a relatively rare cause of pain after arthroplasty. This condition is characterized by pain on active flexion and an absence of signs or symptoms of loosening or infection. In this report, we describe the case of a patient who had signs and symptoms of iliopsoas tendonitis secondary to the protrusion of an acetabular fixation screw through the ilium after primary total hip arthroplasty. Nonoperative treatment was ineffective, and the patient ultimately underwent surgical removal of the screw. The severity of the patient's symptoms decreased significantly after the operation.

Section snippets

Case Report

A 56-year–old woman underwent a primary left THA after presenting with unilateral osteoarthritis-related pain of 3 years' duration. Cementless acetabular (Trilogy; Zimmer, Warsaw, IN) and femoral components (Versys, Zimmer) were used, and the early postoperative period was uncomplicated. Postoperative anteroposterior (AP) and lateral radiographs revealed that an acetabular screw (35 mm) routinely used by the surgeon for initial cup fixation was long and protruded into the pelvis. All

Discussion

The iliopsoas tendon follows a pulley system that consists of the anterior border of the acetabulum, convex surface of the femoral head, and its anterior capsule and finally inserts into the posteroinferior portion of the greater trochanter [8]. It has been hypothesized that this anatomical pulley system is altered in THA with the removal of the femoral head. Thus, the iliopsoas tendon may run in a more direct line and be disposed to make contact with the anteromedial rim of the acetabular

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