Total hip arthroplasty has been associated with the onset of low back pain, which can significantly impact patients' quality of life. However, a detailed evaluation of the time until the onset of long-term low back pain following total hip arthroplasty remains largely unknown. This study aimed to explore the relationship between total hip arthroplasty and the development of long-term lower back pain. Through survival analysis, we examined the time of onset of low back pain in a cohort of patients who underwent the procedure, providing a detailed temporal perspective of this postoperative complication. The onset of low back pain in patients undergoing total hip arthroplasty tends to manifest in the medium and long term. A survival study using the Kaplan-Meier method was conducted on 299 patients who underwent total hip arthroplasty between 2010 and 2020 at the Hospital Clínico Universitario Lozano Blesa in Zaragoza. The event of interest was the occurrence of low back pain during monthly follow-ups, which was subsequently stratified by sex and body mass index (BMI). Death and the end of the study follow-up were considered as censored data. The sample comprised 67.6% men and 32.4% women. Additionally, 68.2% of patients were overweight or had grade 1 obesity. During the follow-up of the entire sample, 96 patients developed low back pain, with 28 cases occurring within the first 2 years. The 50% survival of the population without low back pain was established at 39 months, with a mean follow-up of 112.25 months (95% CI 105.87-118.62). Significant differences were observed in the onset of lower back pain in men when considering different BMI grades. However, no significant differences were found between sexes or among different BMI groups when gender was not taken into account. The results of this study provide valuable information on the survival of patients undergoing total hip arthroplasty who experienced low back pain over an extensive follow-up period. These findings have significant implications for clinical practice, indicating that patients undergoing total hip arthroplasty should be informed of this potential risk. IV; retrospective case series study.

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 ...

Low back pain (LBP) is a potential complication after total hip arthroplasty (THA). However, some studies suggest that THA not only alleviates joint pain but also resolves LBP in up to 88.2% of patients. Most of these observations are limited to short-term follow-ups. This study investigates the long-term relationship between THA and LBP, challenging the notion that THA resolves LBP. A retrospective review was conducted on 236 patients who underwent THA (2010–2020). Multiple statistical models were applied, including unadjusted unmatched, adjusted unmatched, adjusted matched, and target trial emulation with 7887 subjects, to evaluate LBP incidence. Of the 236 patients, 119 developed postoperative LBP. The unadjusted unmatched analysis showed a relative risk (RR) of 2.23 (95%CI: 1.5–3.2). Adjusting for age, sex, body mass index (BMI), and recruitment period reduced the RR to 1.64 (95%CI: 1.0–2.6). The adjusted matched analysis showed an RR of 1.09 (95%CI: 0.4–3.0), while the target trial emulation simulated an RR of 1.03 (95%CI: 0.7–1.8), indicating no significant differences. Despite an apparent initial association, adjusted analyses do not support a significant long-term relationship between THA and LBP. No reduction in postoperative LBP incidence was observed, suggesting THA is safe regarding LBP risk but lacks a curative effect. Rigorous confounding adjustment is essential in retrospective studies.

Background: Focal hand dystonia is a movement disorder that causes involuntary and painful contractions in the muscles of the forearm and hand, affecting fine manual dexterity and activities such as playing instruments or writing. In contrast, carpal tunnel syndrome is a neuropathy that leads to tingling and weakness in the hand due to compression of the median nerve. Case presentation: We present the case of a woman with a clinical history of compressive syndrome of the median nerve of 2 years’ duration and a diagnosis of focal dystonia of the flexor pollicis longus. Botulinum toxin injections were administered, resulting in an improvement of symptoms. Clinical discussion: Despite the improvement from botulinum toxin treatment, carpal tunnel release surgery could not be avoided due to the persistent involvement of the median nerve. Botulinum toxin injection appears to be a useful treatment in such cases and may help to manage symptoms effectively if applied early. Conclusion: In this case, early administration of botulinum toxin might have improved the patient’s quality of life by delaying or avoiding the need for surgery, underscoring the importance of timely diagnosis and intervention.