Residual groin XXXX at a minimum of two years after metal-on-metal THA with a twenty-eight-millimeter femoral head, THA with a large-diameter femoral head, and hip resurfacing.

@entity1 @entity691 @entity158
BACKGROUND: Groin @entity158 may persist in up to 4.3% of @entity1 after total hip arthroplasty and up to 18% of @entity1 one year after hip resurfacing. The incidence of this problem after total hip arthroplasty with a large-diameter femoral head is unknown. METHODS: We analyzed the natural history of groin @entity158 and its clinical consequences during the first two years after three types of hip arthroplasty. Data were collected prospectively on 279 @entity1 . Eighty-five @entity1 had a @entity691 sandwich metal-on-metal total hip arthroplasty with a 28-mm-diameter femoral head, 105 had hip resurfacing, and eighty-nine had a total hip arthroplasty with a large-diameter femoral head component with three other cup designs (forty-nine in this group had the same monoblock acetabular cup design as those who had hip resurfacing). RESULTS: At the twenty-four-month follow-up evaluation, seventy-seven @entity1 (28%) reported at least one @entity158 area around the hip and thirty-four @entity1 (12.2%) had @entity158 at more than one location. At three months, the incidence of groin discomfort was significantly increased in those who had hip resurfacing (30.5%) and in those who had total hip arthroplasty with a large-diameter femoral head (30%) compared with those who had total hip arthroplasty with a 28-mm femoral head (18.3%). This incidence decreased at two years (14.9%, 16.9%, and 12.9%, respectively). At twenty-four months postoperatively, eleven (four who had hip resurfacing, six who had total hip arthroplasty with the large-diameter head, and one who had total hip arthroplasty with the 28-mm head) of forty-one @entity1 who had groin @entity158 had not reported groin @entity158 at previous follow-up evaluations. Of the forty-one @entity1 reporting groin @entity158 at the time of the last follow-up, twenty-three @entity1 (56%) did not seek further evaluation or treatment, nine had revision surgery (22%), and the remaining nine @entity1 thought the @entity158 was substantial enough to warrant further evaluation and treatment. CONCLUSIONS: When the exact source of groin @entity158 cannot be found after total hip arthroplasty, careful follow-up should be done as local reactions to metal-on-metal implants and component loosening may take time to become apparent clinically or on imaging studies.
