An unusual case of hip pain after total hip arthroplasty: A case report
András Gömöri1
, János Gombos2, Miklós Papp3
1Department of Traumatology, County Hospital and University Hospital, Miskolc, Hungary
2Nuclear Medicine Laboratory, County Hospital and University Hospital, University of Miskolc Faculty of Health Care, Miskolc, Hungary
3Department of Orthopedics, County Hospital and University Hospital, University of Miskolc Faculty of Health Care, Miskolc, Hungary
Keywords: Duplex ultrasound. iliopectineal bursitis, surgery, synovial bursa, total hip arthroplasty
Abstract
Our goal is to draw attention to the inflammation of the iliopectineal bursa being a rare condition, which can cause lower limb swelling and anterior pain of the hip even years after total hip arthroplasty. A 67-year-old woman was admitted seven years after hip arthroplasty (cemented total endoprosthesis [TEP]) with swelling and feeling of excessive fullness of the lower extremity and with tolerable anterior hip pain. The physical examination and blood tests were non-specific for septic condition. Ultrasound showed a cystic mass in the inguinal region with a direct contact to the common femoral vein. Deep vein thrombosis was excluded. The single-photon emission computed tomography-computed tomography (SPECT-CT) was administered to decide the surgical plan, either making a bursa extirpation or making revision hip arthroplasty. The SPECT-CT excluded the possibility of aseptic loosening. Methylene blue was injected into the bursa intraoperatively which did not enter the strong pseudo-capsule of the joint and, therefore, we did not administer revision of the TEP, and the bursa was extirpated. Two weeks after the operation, the patient had no pain, was able to walk, and the swelling decreased. Four months after surgery, the pain and feeling of fullness disappeared, with minimal lower limb swelling. In conclusion, in case of increasing complaints of patients who left years behind without any problem following total hip arthroplasty, the pathogenic role of the iliopectineal bursa should be taken into account, after excluding more frequent causes such as aseptic loosening or periprosthetic joint infection. As long as we consider about a rare disease, we can find a solution to the patient’s complaint sooner.
Citation: Gömöri A, Gombos J, Papp M. An unusual case of hip pain after total hip arthroplasty: A case report. Jt Dis Relat Surg 2021;32(2):546-550.
The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.
The authors received no financial support for the research and/or authorship of this article.