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全髋关节置换术后迟发性髂腰肌肌腱炎伴肌内血肿

Delayed Onset Iliopsoas Tendonitis With Intramuscular Hematoma Following Total Hip Arthroplasty.

作者信息

Orton Kevin S, Stern Jonathan M, Cruz-Ossa Natalia, Hung Freddy A, Fernandez-Perez Antonio, Jose Jean, Hernandez Victor Hugo

机构信息

Department of Orthopaedics, University of Miami Hospital, Miami, FL, USA.

Department of Radiology, University of Miami Hospital, Miami, FL, USA.

出版信息

Arthroplast Today. 2024 Dec 9;30:101589. doi: 10.1016/j.artd.2024.101589. eCollection 2024 Dec.

DOI:10.1016/j.artd.2024.101589
PMID:39735212
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11681829/
Abstract

Iliopsoas tendonitis following total hip arthroplasty (THA) can be challenging to diagnose due to the many causes of postoperative groin pain. This case involves a 66-year-old female with right-sided hip and groin pain and a palpable mass, 3 years post-THA. Initial recovery was unremarkable until the sudden onset of symptoms after exercise. The patient presented with a palpable mass on the groin area and pain and underwent several consults with general surgery and orthopaedics. A series of unremarkable radiogram, biopsies, and negative infectious workup prompted revision surgery, which included acetabular component revision and iliopsoas tenotomy. The patient experienced significant pain relief and improved mobility postrevision. This case highlights a complication of THA and the complexity of diagnosing and treating iliopsoas tendonitis post-THA.

摘要

由于全髋关节置换术（THA）后腹股沟疼痛的原因众多，髂腰肌肌腱炎的诊断可能具有挑战性。本病例涉及一名66岁女性，在全髋关节置换术后3年出现右侧髋部和腹股沟疼痛以及可触及的肿块。最初恢复情况良好，直到运动后突然出现症状。患者腹股沟区有可触及的肿块并伴有疼痛，曾多次咨询普通外科和骨科医生。一系列无异常的X线片、活检及阴性的感染检查结果促使进行翻修手术，包括髋臼部件翻修和髂腰肌肌腱切断术。翻修术后患者疼痛明显缓解，活动能力改善。本病例突出了全髋关节置换术的一种并发症以及全髋关节置换术后髂腰肌肌腱炎诊断和治疗的复杂性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/059c/11681829/9bfb6992ca2e/gr10.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/059c/11681829/c0192c281485/gr9.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/059c/11681829/9bfb6992ca2e/gr10.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/059c/11681829/122ed7af7e67/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/059c/11681829/a8fb250c71c4/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/059c/11681829/f04976bc7fd8/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/059c/11681829/b42f254324c2/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/059c/11681829/89d40e1be281/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/059c/11681829/1ef0251dc880/gr6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/059c/11681829/e505dfe395db/gr7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/059c/11681829/f3ebac24b6f2/gr8.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/059c/11681829/c0192c281485/gr9.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/059c/11681829/9bfb6992ca2e/gr10.jpg

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本文引用的文献

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J Arthroplasty. 2023 Aug;38(8):1621-1627. doi: 10.1016/j.arth.2023.01.037. Epub 2023 Jan 30.
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A Case of Iliopsoas Bursitis With Compressive Femoral Nerve Palsy Treated With Iliopsoas Tendon Release.一例采用髂腰肌肌腱松解术治疗的伴有股神经受压性麻痹的髂腰肌滑囊炎病例。
Arthroplast Today. 2022 Mar 18;14:148-153. doi: 10.1016/j.artd.2022.02.004. eCollection 2022 Apr.
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Iliopsoas Bursitis Managed with Endoscopic Bursectomy and Lesser Trochanter Decompression: A Case Report.
采用内镜下囊切除术和小转子减压术治疗髂腰肌滑囊炎：病例报告。
JBJS Case Connect. 2021 Nov 11;11(4):01709767-202112000-00044. doi: e21.00285.
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Hematoma following total elbow arthroplasty: incidence, management, and outcomes.全肘关节置换术后血肿：发生率、处理及结果
Shoulder Elbow. 2021 Oct;13(5):538-543. doi: 10.1177/1758573219896050. Epub 2020 Jan 10.
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Iliopsoas Impingement After Direct Anterior Approach Total Hip Arthroplasty: Epidemiology, Risk Factors, and Treatment Options.直接前入路全髋关节置换术后髂腰肌撞击征：流行病学、危险因素和治疗选择。
J Arthroplasty. 2021 May;36(5):1772-1778. doi: 10.1016/j.arth.2020.12.012. Epub 2020 Dec 13.
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Risk Factors and Cup Protrusion Thresholds for Symptomatic Iliopsoas Impingement After Total Hip Arthroplasty: A Retrospective Case-Control Study.全髋关节置换术后症状性腰大肌撞击综合征的危险因素和杯突阈值：一项回顾性病例对照研究。
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Tendon Disorders After Total Hip Arthroplasty: Evaluation and Management.全髋关节置换术后的肌腱疾病：评估与管理
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