Volume 25, Issue 4 (Winter- In Press 2025)
jrehab 2025, 25(4): 0-0 |
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Gallego Peñalver F J, Cía Blasco P, Gómez Trullén E M. Unilateral Psoas Muscle Atrophy as a Possible Risk Factor for Low Back Pain After Total Hip Arthroplasty: A Case Report. jrehab 2025; 25 (4)
URL: http://rehabilitationj.uswr.ac.ir/article-1-3463-en.html
URL: http://rehabilitationj.uswr.ac.ir/article-1-3463-en.html
1- Department of Physical Medicine and Nursing. University of Zaragoza. iHealthy Research Group. C. Domingo Miral, s/n, 50009, Zaragoza. España. , 823591@posta.unizar.es
2- Head of the Paint Unit, Hospital Universitario Lozano Blesa. C. San Juan Bosco, 15, 50009, Zaragoza. Spain., C. San Juan Bosco, 15, 50009, Zaragoza. Spain.
3- Department of Physical Medicine and Nursing. University of Zaragoza. iHealthy Research Group. C. Domingo Miral, s/n, 50009, Zaragoza. España., C. Domingo Miral, s/n, 50009, Zaragoza. España
2- Head of the Paint Unit, Hospital Universitario Lozano Blesa. C. San Juan Bosco, 15, 50009, Zaragoza. Spain., C. San Juan Bosco, 15, 50009, Zaragoza. Spain.
3- Department of Physical Medicine and Nursing. University of Zaragoza. iHealthy Research Group. C. Domingo Miral, s/n, 50009, Zaragoza. España., C. Domingo Miral, s/n, 50009, Zaragoza. España
Abstract: (2022 Views)
Introduction: The psoas muscle plays an essential role in the hip and lumbar spine. Total hip arthroplasty surgery can lead to alterations in the ipsilateral psoas muscle that may affect lumbar biomechanics and accelerate disc degeneration. We introduce a clinical study that suggests the theory of a potential association between unilateral psoas muscle atrophy after hip replacement surgery and subsequent low back pain.
Case description: A 53-year-old man with a history of right total hip arthroplasty for osteoarthritis presented with left lumbosciatalgia six years after surgery. In the physical examination, the patient exhibited weakness 2/5 in Kendall´s muscle grading system in the right hip flexion and left extensor hallucis longus and triceps surae. Magnetic resonance imaging revealed a degenerative disk L5-S1 and severe unilateral atrophy of the right psoas muscle. Conservative treatment through physiotherapy was initiated, but persistent pain ultimately necessitated microdiscectomy at the L5–S1 level.
Conclusion: Total hip arthroplasty surgery may lead to long-term unilateral atrophy of the ipsilateral psoas muscle and alter lumbar biomechanics, potentially accelerating the disc degeneration process and subsequent low back pain. Investigating this possible correlation may offer greater clarity regarding low back pain after total hip arthroplasty. In our case, conservative treatment through 15 sessions of physical therapy produced very limited improvement, and advanced discopathy required surgical intervention to decompress the affected lumbar root.
Case description: A 53-year-old man with a history of right total hip arthroplasty for osteoarthritis presented with left lumbosciatalgia six years after surgery. In the physical examination, the patient exhibited weakness 2/5 in Kendall´s muscle grading system in the right hip flexion and left extensor hallucis longus and triceps surae. Magnetic resonance imaging revealed a degenerative disk L5-S1 and severe unilateral atrophy of the right psoas muscle. Conservative treatment through physiotherapy was initiated, but persistent pain ultimately necessitated microdiscectomy at the L5–S1 level.
Conclusion: Total hip arthroplasty surgery may lead to long-term unilateral atrophy of the ipsilateral psoas muscle and alter lumbar biomechanics, potentially accelerating the disc degeneration process and subsequent low back pain. Investigating this possible correlation may offer greater clarity regarding low back pain after total hip arthroplasty. In our case, conservative treatment through 15 sessions of physical therapy produced very limited improvement, and advanced discopathy required surgical intervention to decompress the affected lumbar root.
Keywords: Total hip replacement, Postoperative complications, Muscular atrophy, Low back pain, Diskectomy
Type of Study: Case report |
Subject:
Rehabilitation Management
Received: 10/03/2024 | Accepted: 3/07/2024 | Published: 28/02/2025
Received: 10/03/2024 | Accepted: 3/07/2024 | Published: 28/02/2025
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This is an open access article distributed under the terms of the Creative Commons Attribution License (CC-By-NC), which permits use, distribution, and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
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