# Groin pain aggravated in short term contracted by COVID-19 in THA patients: a case-crossover study

## TL;DR

This study finds that patients who had hip replacement surgery and later contracted COVID-19 experienced worsened groin pain, with longer hospital stays linked to higher risk.

## Contribution

The study is the first to investigate the link between postoperative groin pain aggravation in THA patients and short-term COVID-19 infection.

## Key findings

- Patients with THA who contracted COVID-19 had a 9.5-fold increased risk of groin pain aggravation.
- Longer hospital stays were independently associated with increased risk of pain aggravation (OR 1.26).

## Abstract

The coronavirus disease 2019 (COVID-19) rapidly spreads worldwide and causes more suffering. The relation about the aggravation of inguinal pain and COVID-19 was unclear in patients with total hip arthroplasty (THA). This study aimed to evaluate the risk of groin pain aggravation in short-term THA patients after COVID-19.

Between 2020 and 2022, 129 patients with THA who were affected COVID-19 were enrolled. A short-standardized questionnaire was administered during follow-up to inquire about the aggravation of groin ache before and after SARS-COV-2 affection. Furthermore, we evaluated the potential association between the presence of increased pain and various factors, including age, gender, body mass index, diagnosis, and length of hospital stay.

The case-crossover study revealed an increased risk of inguinal soreness aggravation when comparing 8 weeks after COVID-19 with 12 weeks before COVID-19 (Relative risk [RR], 9.5; 95% Confidence intervals [CI], 2.259–39.954). For COVID-19 positive patients, multivariate analysis showed length of stay was an independent factor significantly associated with increased risk of aggravation of groin pain (Odds ratio [OR], 1.26; 95%CI, 1.03–1.55, p = 0.027).

This study confirms the association between COVID-19 and the exacerbation of soreness in the groin region in THA patients and extended length of stay is a possible contributing factor. This study expands the current literature by investigating the risk of aggravation of inguinal pain in patients with THA after COVID-19, providing valuable insights into postoperative outcomes in this specific population.

Trial registration This retrospective study was approved by the Institutional Review Board of Shanghai general hospital (No.2023-264).

The online version contains supplementary material available at 10.1186/s13018-024-04862-1.