Metal-on-metal hip resurfacing is offered as an alternative to traditional THA for the young and active adult with advanced osteoarthritis. However, patients undergoing hip resurfacing may be predisposed to persistent groin pain due to insufficient head/neck offset, an uncovered acetabular component, or both. We therefore determined the incidence of groin pain after metal-on-metal hip resurfacing, its impact on patient function, and possible risk factors contributing to groin pain. We evaluated 116 patients with a followup of at least 12 months after surgery (mean, 26 months; range, 12-61 months). The mean age was 48.8 years (range, 24.0-66.3 years), with 21 women (18%) and 95 men (82%). All patients were evaluated clinically and radiographically and had a Harris hip score, WOMAC, UCLA Activity Rating Scale, and the RAND-36 General Health measure; they were specifically asked if they experienced groin pain currently or since their surgery. Although all patients had functional improvements postoperatively, 21 of 116 of the patients (18%) reported groin pain; 12 of these (10% of the total) stated the pain limited their activities of daily living and 11 (10%) required medication for pain. Female patients were at greater risk of having groin pain. Of the patients with groin pain, three patients had muscle atrophy with a joint effusion on CT; one of these patients had revision surgery for the pain. Patients with metal-on-metal resurfacing may have a higher incidence of pain than those with conventional THA.
Level of evidence: Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.