Total hip arthroplasty (THA) is a progressively refined orthopaedic surgery with excellent long-term survival rates, but it still faces problems such as postoperative pain, infection and loosening, especially groin pain. Iliopsoas impingement (IPI) is a relatively rare and overlooked cause of groin pain after THA, which often leads to delayed diagnosis and inappropriate treatment due to lack of awareness. IPI refers to the pain in the groin area caused by abnormal contact between the iliopsoas and the front of the acetabulum. There are many risk factors for IPI after THA including acetabular cup protrusion, osteophyte impingement, screw protrusion, bone cement extravasation, improper placement of acetabular prosthesis, and changes in lower limb length. The diagnosis of IPI is primarily based on physical examination, imaging findings, and a diagnostic treatment of pain relief following fluoroscopic or ultrasound-guided injection of corticosteroids and local anesthesia into the iliopsoas tendon sheath. Other potential causes such as hip dislocation, periprosthetic infection, loosening or fracture should be excluded. Treatment of IPI includes non-surgical treatment (non-steroidal anti-inflammatory drugs, physical therapy and ultrasound-guided injections of corticosteroids and local anesthesia in the iliopsoas tendon sheath), iliopsoas tenotomy, and acetabular cup revision, all three of which should be performed stepwise to maximize patient benefit.

Total hip arthroplasty (THA) is a progressively refined orthopaedic surgery with excellent long-term survival rates, but it still faces problems such as postoperative pain, infection and loosening, especially groin pain. Iliopsoas impingement (IPI) is a relatively rare and overlooked cause of groin pain after THA, which often leads to delayed diagnosis and inappropriate treatment due to lack of awareness. IPI refers to the pain in the groin area caused by abnormal contact between the iliopsoas and the front of the acetabulum. There are many risk factors for IPI after THA including acetabular cup protrusion, osteophyte impingement, screw protrusion, bone cement extravasation, improper placement of acetabular prosthesis, and changes in lower limb length. The diagnosis of IPI is primarily based on physical examination, imaging findings, and a diagnostic treatment of pain relief following fluoroscopic or ultrasound-guided injection of corticosteroids and local anesthesia into the iliopsoas tendon sheath. Other potential causes such as hip dislocation, periprosthetic infection, loosening or fracture should be excluded. Treatment of IPI includes non-surgical treatment (non-steroidal anti-inflammatory drugs, physical therapy and ultrasound-guided injections of corticosteroids and local anesthesia in the iliopsoas tendon sheath), iliopsoas tenotomy, and acetabular cup revision, all three of which should be performed stepwise to maximize patient benefit.

Objective To compare the antibody persistence 5 years after primary immunization with 5 μg and 10 μg recombinant hepatitis B vaccine (HepB) among newborns with normal and high response.Methods Newborns who completed three doses of 5 μ g HepB made by recombinant dexyribonucleic acid technique in Saccharomyces (HepB-SC) or 10 μg HepB made by recombinant dexyribonucleic acid technique in Hansenula polymorpha (HepB-HP) were recruited.Standardized questionnaire was used and blood samples were collected 1-6 months (T0) and five years (T1) after the third dose respectively.The titer of anti-HBs was detected by chemiluminescence microparticle imunoassay (CMIA).Those who achieved normal or high antibody response (anti-HBs titer ≥100 mIU/ml) were included in the study and the positive rate (≥ 10 mIU/ml) and titer of anti-HBs at T1 were compared between 5 μg HepB group and 10 μg HepB group.Multivariable analysis was conducted to identify the independent factors associated with the antibody persistence.Results The positive rate of anti-HBs at T1 was 49.92％ (943/1 883) and 75.92％ (1 135/1 495) respectively in 5 μg HepB group and 10 μg HepB group,the difference was significant (x2=237.75,P＜0.001).The anti-IBs geometric mean concentrations at T1 were 10.23 mIU/ml (95％CI:9.38-11.16) and 28.91 mIU/ml (95％CI:26.65-31.35) in the two groups respectively,the difference was also significant (F=280.36,P＜0.001).Among those whose anti-HBs titer was ＜ 10 mIU/ml at T1,the distributions of anti-HBs titer were significantly different between 5 μg HepB group and 10 μg HepB group (x2=39.75,P＜ 0.001).The multivariable analysis showed that dosage of HepB was independently associated with both positive rate and titer of anti-HBs at T1 after excluding the other factors [P＜0.001,OR=1.44(95％ CI:1.20-1.73);P＜0.001,β =0.27 (95％ CI:0.14-0.40)].Conclusion Five year anti-HBs persistence after primary immunization with 10 μg HepB might be better than that after primary immunization with 5 μg HepB among infants who achieved normal or high anti-HBs response after primary HepB immunization.