Painful total hip arthroplasty

Abstract Total hip arthroplasty (THA) is a common surgical procedure that improves patients' quality of life and function with great and reproducible success. However, long-term pain is experienced in 7–23% of patients. This article discusses potential predisposing factors, their aetiology and the subsequent evaluation of persisting pain after THA. A thorough, structured approach to clinical history and examination allied with knowledge of potential differential diagnoses will help focus subsequent investigations to determine the cause. Diagnosis allows the provision of the most appropriate nonoperative or operative treatment course.