Analysis of Radiographic Parameters Predisposing to Pain Following Total Hip Arthroplasty and Bipolar Hip Hemiarthroplasty

Abstract

Background: Persistent pain following total hip arthroplasty (THA) and bipolar hip hemiarthroplasty (BHHA) has been considered as a main source of patient dissatisfaction. The aim of this study is to determine the correlation between radiographic findings and painful total/partial hip arthroplasty.

Materials and Method: One hundred sixty BHHA and one hundred forty-eight THA patients responded to a pain-diagram questionnaire and postoperative radiographic measurements of component positioning and bone morphology were performed to determine statistical correlation between radiographic signs and pain after THA/BHHA.

Results: An acetabular inclination angle of ≧ 50° and outer head uncoverage/inclination angle of >7.0mm/<30° trended towards a significant association with groin pain, respectively, in THA and BHHA cohort. An increased distal-third canal fill ratio and a lower canal calcar ratio trended towards a higher incidence of thigh pain in THA and BHHA cohort, as did cement mantle thickness/filling grade(<2m in lateral view/C,D) in BHHA cohort.

Conclusion: Potential correlation between radiographic findings and postoperative pain could provide with a new predictor of patients’ QOL and a possibility of proper preventive measures against undesirable events after hip arthroplasty.