Unexplained Groin Pain After THA? Why It's Probably Iliopsoas Tendinitis

A review of diagnosis and treatment options for iliopsoas tendinitis and abductor tendon deficiency, two frequently overlooked causes of painful total hip arthroplasty.

A painful hip following total hip arthroplasty (THA) is concerning to patients and surgeons, particularly in the setting of satisfactory postoperative radiographs. Traditionally, most painful hips are caused by periprosthetic joint infection, component loosening, and instability. However, other less commonly reported causes of painful THAs persist and can be related to musculotendinous deficiencies, which include iliopsoas tendinitis and abductor mechanism disruption.

These frequently underdiagnosed deficiencies are poorly understood in the literature and, therefore, challenging to resolve. Only a few studies exist evaluating the treatment options for these deficiencies, and moreover, most of them are limited by small sample sizes. We set out to review the current peer-reviewed evidence for the diagnosis and treatment of these frustrating clinical scenarios.