Published online Nov 16, 2021. doi: 10.12998/wjcc.v9.i32.10006
Peer-review started: July 2, 2021
First decision: July 16, 2021
Revised: July 19, 2021
Accepted: September 8, 2021
Article in press: September 8, 2021
Published online: November 16, 2021
Processing time: 130 Days and 21.3 Hours
Postoperative pain following total hip arthroplasty (THA) may occur in a few patients but may pose a significant challenge to surgeons if the etiology is not identified. Herein, we report the case of a patient who developed late-onset pain following THA due to screw penetration of the iliopsoas tendon.
We report the case of a 77-year-old man who developed inguinal pain 7 years after THA. While the symptoms resembled that of iliopsoas impingement by the acetabular cup, the pain resolved only when the supplementary acetabular screw protruding through the ilium was decompressed. Decompression was performed using the pararectus approach. The patient was able to ambulate pain-free immediately after surgery.
A protruded screw through the ilium may penetrate the iliopsoas muscle, causing pain following THA. Pain may resolve with the decompression of the protruded screw.
Core Tip: The acetabular screws are mostly positioned in the posterolateral quadrant and rarely protrude through the anterior ilium. However, when supplementary screw is protruded anteriorly and penetrate through iliopsoas muscle, the symptom may resemble that of the iliopsoas impingement by acetabular cup. Instead of removing the entire screw, which would require dislocation of the hip and disassembly of the ceramic liner, flatten the protruded portion of the screw with the para-rectus approach may relieve the symptom.