Unilateral Psoas Muscle Atrophy as a Possible Risk Factor for Low Back Pain After Total Hip Arthroplasty: A Case Report
Gallego-Pen~alver, Francisco José ; Cía-Blasco, Pedro ; Gómez-Trullén, Eva María (Universidad de Zaragoza)
Resumen: Introduction The psoas muscle plays an essential role in the hip and lumbar spine. Total hip arthroplasty surgery can change the ipsilateral psoas muscle, which may affect lumbar biomechanics and accelerate disk degeneration. We present a clinical study that suggests 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 6 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 disk degeneration 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 resulted in very limited improvement, and advanced diskopathy required surgical intervention to decompress the affected lumbar root.
Idioma: Inglés
DOI: 10.32598/RJ.25.4.3883.1
Año: 2025
Publicado en: Archives of Rehabilitation 25, 4 (2025), 890-905
ISSN: 2538-6247
Tipo y forma: Article (Published version)
Área (Departamento): Área Educación Física y Depor. (Dpto. Fisiatría y Enfermería)
You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use. You may not use the material for commercial purposes.
Exportado de SIDERAL (2026-01-30-12:20:59)
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Case description A 53-year-old man with a history of right total hip arthroplasty for osteoarthritis presented with left lumbosciatalgia 6 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 disk degeneration 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 resulted in very limited improvement, and advanced diskopathy required surgical intervention to decompress the affected lumbar root.
Idioma: Inglés
DOI: 10.32598/RJ.25.4.3883.1
Año: 2025
Publicado en: Archives of Rehabilitation 25, 4 (2025), 890-905
ISSN: 2538-6247
Tipo y forma: Article (Published version)
Área (Departamento): Área Educación Física y Depor. (Dpto. Fisiatría y Enfermería)
You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use. You may not use the material for commercial purposes. Exportado de SIDERAL (2026-01-30-12:20:59)
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Record created 2026-01-30, last modified 2026-01-30