Ileopectineal bursitis following total hip replacement

Kolmert, L; Persson, Björn M.; Herrlin, Kristian; Ekelund, Leif

doi:10.3109/17453678408992314

Cited by 42 publications

(9 citation statements)

References 6 publications

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“…Ilio-psoas impingement was first suspected to cause pain in 1975 by Postel, and was later described by Kolmert et al (1984), Lequesne et al (1991), and Trousdale et al (1995). Furthermore, 2 series were reported in France-9 cases by Ala Eddine et al (2001) and 12 cases by Bricteux et al (2001).…”

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confidence: 94%

Hemispheric cups do not reproduce acetabular rim morphology

et al. 2007

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Background Iliopsoas impingement is a recurrent complication following THA, caused by muscle friction against a protrusive prosthetic cup. This study was designed to quantify the dimensional variations in acetabular rim profiles, with particular regard to the iliopubic valley, in order to suggest means to prevent iliopsoas impingement.Material and methods 34 cadaver pelvises were analyzed using a hip navigation system. The morphometric data were processed to plot profiles of all acetabular rims with particular regard to the shape and depth of the psoas valley.Results The acetabular rim is an asymmetric succession of 3 peaks and 3 troughs. The psoas valley is a salient feature in most pelvises and there is only a weak correlation between its depth (mean 3.8 mm, SD 2.0) and acetabular diameter, anteversion, or inclination.Interpretation It would be difficult to obviate the anterior overlap of the acetabulum using a hemispheric cup, a fortiori in certain morphotypes, without compromising range of motion or risk of dislocation. The solution for prevention of iliopsoas impingement would be to adapt cup design to acetabular anatomy, which may require different implants for the right and left sides, and hence a doubled inventory.

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confidence: 94%

Hemispheric cups do not reproduce acetabular rim morphology

et al. 2007

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“…A well-known complication of anterior cup overlap after THA is iliopsoas impingement caused by chronic friction between the iliopsoas tendon and the rim of the implant [3,5,16,21,27,33]. A review of the scarce literature on the syndrome suggests an incidence of approximately 5% of all THAs [3,5].…”

Section: Introductionmentioning

confidence: 99%

“…A review of the scarce literature on the syndrome suggests an incidence of approximately 5% of all THAs [3,5]. The incidence is difficult to estimate because the syndrome takes various clinical forms and because the diagnosis criteria vary among authors [3,5,16,21,33]. In our experience, the syndrome can occur with all acetabular implants, but it is observed more frequently in cases in which the implant is oversized, insufficiently anteverted, or protrudes as a result of insufficient reaming.…”

Section: Introductionmentioning

confidence: 99%

The Asymmetric Profile of the Acetabulum

Vandenbussche

Saffarini

Taillieu

et al. 2008

Clinical Orthopaedics &Amp; Related Research

102

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Despite the curvaceous profile of the acetabulum, orthopaedic surgeons have continued to implant hemispheric cups since the introduction of total hip arthroplasty. The geometric discrepancies between the natural acetabulum and implant can result in painful iliopsoas impingement attributable to prosthetic overlap at the anterior acetabular ridge over which the iliopsoas tendon extends to leave the pelvis. We expanded on previous in vitro observations of acetabular morphology using a large in vivo sample and quantified the dimensions of the psoas valley. We studied computed tomographic scans of 200 healthy hips from 50 men and 50 women. The acetabular ridges were digitized on three-dimensional bone reconstructions and their coordinates were manipulated in spreadsheets to deduce acetabular diameter, anteversion, and inclination and to plot the rim profile. Our results confirm the acetabular rim is an asymmetric succession of three peaks and three troughs. The psoas valley has the following shape distribution: 79% curved, 11% angular, 10% irregular, and 0% straight. The mean depth of the psoas valley is 5 mm and the latitude of its trough is on average 6 mm below the acetabular equator. The use of side-specific cups that replicate the curvaceous acetabular profile could prevent prosthetic overlap and reduce the incidence of iliopsoas impingement.

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“…In 2 cases of iliopectineal bursitis reported by Kolmert et al (1984), polyethylene was not described as the initiating factor, although microscopy revealed a foreign body reaction. None of these reports mentioned a vascular complication due to polyethylene wear.…”

Section: Discussionmentioning

confidence: 99%