Complications of Hip Revision

Complications of Hip Revision


Hip, groin, anterior thigh pain after THA can result from a multitude of etiologies. In general, when trying to establish the diagnosis, it is helpful to divide the possible causes into two broad categories:

  • Those that are directly related to the hip prosthesis
  • Those that are not related to the hip replacement

Evaluation must begin with a thorough history and physical examination; afterwards, laboratory tests, plain radiographs, arthrocentesis, and additional imaging can provide more information. Only after the diagnosis has been established should treatment be initiated. Any form of surgical intervention before a definitive diagnosis have been made must be avoided.

Intrinsic Factors

  • Loosening
  • Infection
  • Instability
  • Impingement
  • Particulate synovitis
  • Modulus mismatch

Local Extrinsic Factors

  • Bursitis
  • Tendinitis
  • Heterotopic ossification
  • Greater trochanter / abductor avulsion fracture
  • Stress fracture

Remote Extrinsic Factors

  • Spinal pathology
  • Neuropathy / nerve palsy
  • Nerve entrapment
  • Peripheral vascular disease
  • Osteitis pubis
  • Hernia
  • Fascia lata / quadriceps herniation
  • Intra-abdominal pathology
  • Tumor


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