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Background Groin pain after total hip arthroplasty (THA) or total hip resurfacing arthroplasty can be troubling for patients and surgeons. Potential sources of pain include infection, loosening, metal hypersensitivity, or impingement of bony structures or the iliopsoas tendon. Questions/purposes We compared the rate of groin pain after THA or hip resurfacing using metal-on-metal to those of other bearing surfaces. Methods We identified 347 (334 patients) primary total hip (n = 301) or resurfacing (n = 46) arthroplasties. Complete preoperative, operative, and postoperative data were available for 282 hips. We retrospectively reviewed the charts for the presence or absence of groin pain at a minimum of 1 year after surgery with a specific focus on etiologic factors. The minimum followup was 12 months (mean, 14 months; range 12 to 24 months). Results The rate of groin pain was 7% (15 of 217 patients) after THA with conventional bearing surfaces, 15% (4 of 26 patients) with metal-on-metal THA and 18% (7 of 39 patients) with total hip resurfacing. Younger patients were more likely to report groin pain postoperatively and more likely to have metal-on-metal bearing surfaces.Conclusions Our data at short-term followup suggest increased rates of groin pain after metal-on-metal THA or resurfacing arthroplasty versus THA using polyethylene or ceramic bearing surfaces. The reasons are not clear but they appear to be associated with younger age. Potential factors include impingement, activity level and possibly higher expectations for patients receiving metal-on-metal bearing surfaces that may make those patients more likely to report postoperative pain.

Eight percent of asymptomatic teenagers had limited internal rotation on examination; 68% of these had radiographic findings suggestive of FAI. More than two thirds of these participants had evidence of asymptomatic hip pathological lesions on MRI.

Patients with dysphagia following anterior cervical arthrodesis were exposed to higher intraoperative esophageal pressure and decreased esophageal mucosal blood flow during surgical retraction as compared with patients without dysphagia. In this small series, dynamic retraction seemed to be associated with a lower prevalence of postoperative dysphagia.

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