Comparison of iliopsoas tendonitis after hip resurfacing arthroplasty and total hip arthroplasty: A case-controlled investigation using a validated simulation

Max Hardwick-Morris, Joshua Twiggs, Brad Miles, Rami M. A. Al-Dirini, Mark Taylor, Jitendra Balakumar, William L. Walter

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)
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Abstract

Iliopsoas tendonitis, typically caused by impingement with the acetabular cup, occurs in up to 18% of patients after total hip arthroplasty (THA) and up to 30% of patients after hip resurfacing arthroplasty (HRA). We have developed a simulation for detecting iliopsoas impingement and validated it in a previous study of THA patients. However, due to the difference in incidence between HRA and THA, this study had two aims. First, to validate the simulation in a cohort of HRA patients and, second, to comparethe results of the HRA and THA patients to understand any differences in their etiology. We conducted a retrospective search in an experienced surgeon's database for HRA patients with iliopsoas tendonitisand control patients without iliopsoas tendonitis, resulting in two cohorts of 12 patients. Using CT scans, 3D models of the each patient's prosthetic and bony anatomy were generated, landmarked, and simulated. Regarding validation of the simulation for HRA patients, impingement significantly predicted the probability of iliopsoas tendonitis in logistic regression models and the simulation had a sensitivity of 83%, specificity of 100%, and an AUC ROC curve of 0.95. Unexpectedly, the HRA cohort exhibited less impingement than the THA cohort. Our novel simulation has now been demonstrated to detect iliopsoas impingement and differentiate between the symptomatic and asymptomatic cohorts in investigations of THA and HRA patients. This tool has the potential to be used preoperatively, to guide decisions about optimal cup placement, and postoperatively, to assist in the diagnosis of iliopsoas tendonitis.

Original languageEnglish
Pages (from-to)1577-1586
Number of pages10
JournalJournal of Orthopaedic Research
Volume42
Issue number7
Early online date17 Feb 2024
DOIs
Publication statusE-pub ahead of print - 17 Feb 2024

Keywords

  • arthroplasty - hip
  • hip
  • modeling
  • muscle
  • tendon

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