Bilateral stress fractures of the pubic rami following THA--an unusual case of groin pain.

Stress fractures of the pubic rami are rare occurrences and most frequently occur in association with total hip arthroplasty (THA). Reported historically with both cemented and noncemented THA components, postoperative stress fractures likely occur secondary to a rapid postoperative increase in patient activity following years of disability. Though stress fractures of the pubic rami should be considered in the differential diagnosis of groin pain following THA, they require a high degree of suspicion. Diagnosis may be achieved via bone scan after ruling out alternative causes of postoperative groin pain and after accounting for associated medical conditions. Treatment is minimally invasive, requiring a limited period of weightbearing and activity modifIcation, often with full resolution of groin pain and a return to postoperative activity levels.