Park HS, Lee SH, Cho HM, Choi HB, Jo S. Screw penetration of the iliopsoas muscle causing late-onset pain after total hip arthroplasty: A case report. World J Clin Cases 2021; 9(32): 10006-10012 [PMID: 34877343 DOI: 10.12998/wjcc.v9.i32.10006]
Corresponding Author of This Article
Suenghwan Jo, MD, PhD, Associate Professor, Department of Orthopaedic Surgery, Chosun University Hospital, 365 Pilmundae-ro, Dong-gu, Gwangju, 61453, South Korea. jo.suenghwan@chosun.ac.kr
Research Domain of This Article
Orthopedics
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Nov 16, 2021; 9(32): 10006-10012 Published online Nov 16, 2021. doi: 10.12998/wjcc.v9.i32.10006
Screw penetration of the iliopsoas muscle causing late-onset pain after total hip arthroplasty: A case report
Hyung-Seok Park, Sang-Hong Lee, Hong-Man Cho, Hyun-Bai Choi, Suenghwan Jo
Hyung-Seok Park, Sang-Hong Lee, Hyun-Bai Choi, Suenghwan Jo, Department of Orthopaedic Surgery, Chosun University Hospital, Gwangju 61453, South Korea
Hong-Man Cho, Department of Orthopedics, Gwangju Veterans Hospital, Gwangju 62284, South Korea
Author contributions: Park HS wrote the initial draft of the paper; Cho HM was the patient’s surgeon and made the initial diagnosis; Lee SH and Choi HB reviewed the literatures and contributed to manuscript drafting; and Jo S made decision on patient’s treatment and made critical revision on the manuscript.
Supported byResearch Fund from Chosun University Hospital, 2019.
Informed consent statement: Approval was waived by the Institutional Review Board of Chosun University Hospital. Written informed consent was obtained from the patient for publication of this case report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared according to the CARE checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Suenghwan Jo, MD, PhD, Associate Professor, Department of Orthopaedic Surgery, Chosun University Hospital, 365 Pilmundae-ro, Dong-gu, Gwangju, 61453, South Korea. jo.suenghwan@chosun.ac.kr
Received: July 2, 2021 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
Abstract
BACKGROUND
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.
CASE SUMMARY
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.
CONCLUSION
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.
