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. 2009 Feb;33(1):65-9.
doi: 10.1007/s00264-007-0470-2. Epub 2007 Oct 30.

Pain after total hip arthroplasty: a psychiatric point of view

V Pacault-Legendre  1 , P Anract, M Mathieu, J P Courpied
Affiliations

Pain after total hip arthroplasty: a psychiatric point of view

V Pacault-Legendre et al. Int Orthop. 2009 Feb.

Abstract
in English, French

After total hip arthroplasty (THA), many studies report that a small percentage of patients mention painful symptoms, whose origin remains more or less obscure. We investigated 1,000 patients who had undergone a THA at least one year before their inclusion in the survey protocol. Among these 1,000 patients, 64 were complaining of pain in the region of the operated hip. These were later examined and investigated, both clinically (physical and psychiatric examination) and paraclinically (radiography, biology). Those requiring it received adequate treatment and the others were only regularly followed up. We identified the cause of all but one patient's pain. In all cases except one, the symptoms of pain without physical cause had a psychiatric origin. The results of our study show that, if the clinical picture is not perfectly clear, a psychiatric screening before surgery could contribute to decreasing the incidence of pain syndrome after THA.

Comme le rapportent de nombreuses études, un pourcentage limité de patients conservent des douleurs après prothèse totale de hanche, douleur dont l'origine reste relativement obscure. Nous avons analysé 1000 patients ayant bénéficié d'une prothèse totale de hanche dont le recul était au moins égal à un an. Parmi ces 1000 patients, 64 se plaignaient de douleurs dans la région de la hanche. Ces patients ont été explorés sur le plan clinique, paraclinique et psychiatrique. Certains ont bénéficié d'un traitement, d'autres ont été seulement régulièrement suivis. Nous avons identifié l'origine de la douleur chez tous les patients (sauf un). Les douleurs qui n'avaient pas une origine somatique étaient d'origine psychiatrique. Les résultats de notre étude montrent que si le tableau clinique n'est pas tout à fait clair, un examen psychiatrique réalisé avant la chirurgie peut contribuer à diminuer les syndromes douloureux après intervention chirurgicale.

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