Successful Treatment of Recurrent Painful Muscle Spasms After Total Hip Arthroplasty With Oxcarbazepine - A Case Report

Sep 28, 2026

Uploaded by Ben

Painful muscle spasms are marked by sudden involuntary contractions with severe pain. Occurrence after total hip arthroplasty (THA) is exceptionally rare. This report describes a patient who developed painful muscle spasms following THA and achieved symptom control with oxcarbazepine. After ruling out prosthetic loosening or dislocation, a management approach including symptomatic therapy and eventual antiepileptic treatment resolved episodes and prevented recurrence during follow-up.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages4

Reading Time10 min

AccessFree to download

Introduction

Case History

Differential Diagnosis

Conclusion and Results (and Follow-Up)

Discussion

Clinical Case Reports CASE REPORT OPEN ACCESS Successful Treatment of Recurrent Painful Muscle Spasms After Total Hip Arthroplasty With Oxcarbazepine: A Case Report Youhan Yang | Wanqin Zheng | Yinxian Wen | Liaobin Chen Department of Joint and Sports Medicine, Zhongnan Hospital, Wuhan University, Wuhan, China Correspondence: Yinxian Wen ([wenyinxian@whu.edu.cn](wenyinxian@whu.edu.cn)) | Liaobin Chen ([lbchen@whu.edu.cn](lbchen@whu.edu.cn)) Received: 29 May 2025 | Revised: 15 October 2025 | Accepted: 21 December 2025 Keywords: case report | oxcarbazepine | painful muscle spasms | total hip arthroplasty | ABSTRACT
Painful muscle spasms are characterized by sudden onset of involuntary muscle contractions accompanying severe pain. The occurrence of painful muscle spasms after total hip arthroplasty (THA) is extremely rare in clinical practice. We report a case in which a patient developed painful muscle spasms after THA, and symptoms were controlled by oxcarbazepine. | | | --- | --- | | 1 | Introduction | aseptic femoral head necrosis and degenerative hip joint disease. After preoperative evaluation, he received bilateral total | | Painful muscle spasms are most common in the elderly and | hip replacement under general anesthesia. Fourteen days post- | | athletes, with onset durations ranging from a few seconds to a | left THA, the patient developed paroxysmal spasmodic pain | | few hours, with an unclear pathogenesis [1], and treatment is | and stiffness in the left hip, gluteus maximus, tensor fasciae | | mainly symptomatic. THA is currently the most commonly used | latae, and quadriceps, which resolved spontaneously within | | treatment for osteonecrosis of the femoral head, and common | hours. Upon readmission, prosthesis loosening or dislocation | | postoperative complications include periprosthetic infection, | was excluded (Figure 1) . He received bed rest, left lower limb | | thromboembolism, loosening of the prosthesis, dislocation, and | skin traction, analgesia, and muscle relaxants (intravenous | | periprosthetic fracture [2]. There are no reports of postoperative | flurbiprofen ester, intramuscular tramadol, oral etipirasone | | complications of painful muscle spasms after THA, and stan- | hydrochloride, and pregabalin), resulting in partial pain re- | | dardized treatment modalities are even less available. This case | lief. He was discharged after symptom improvement but expe- | | highlights the potential efficacy of antiepileptic drugs like ox- | rienced a relapse on the 26th postoperative day with similar | | carbazepine in this peripheral disorder and offers insights for diagnosing and treating similar conditions. | symptoms. | | 2 | Case History | 2.1 | Differential Diagnosis | | A 46-year-old male was admitted for intermittent right hip | The more common causes of postoperative pain after THA are loosening of the prosthesis and infection around the joint | | pain and limited movement for 1 week, worsening over 2 days, | prosthesis. After ruling it out by X-ray and laboratory tests, we | | with a long history of alcohol consumption. Based on clinical | diagnosed painful muscle spasm in conjunction with the pa- | | findings, imaging, and history, he was diagnosed with bilateral | tient's history and empirically treated it symptomatically. As | | Youhan Yang and Wanqin Zheng contributed equally to this study. | | | This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
© 2026 The Author(s). Clinical Case Reports published by John Wiley & Sons Ltd. | | Clinical Case Reports, 2026; 14:e71796 1 of 4 [https://doi.org/10.1002/ccr3.71796](https://doi.org/10.1002/ccr3.71796) pure analgesic treatment failed to alleviate symptoms, aminophenol hydrocodone and flurbi

FAQs

Why were prosthesis problems considered and how were they handled?

Prosthesis loosening or dislocation was evaluated and excluded using imaging findings. This supported diagnosing painful muscle spasm rather than mechanical failure.

What role did oxcarbazepine play in treatment?

Oxcarbazepine, a sodium channel blocker, was used when symptoms persisted despite initial symptomatic therapy. It controlled the periprosthetic muscle spasms effectively.

How did the patient’s condition change over follow-up?

After a 2-week oxcarbazepine course, there was no recurrence of muscle spasm. No recurrence of the disease was reported during a 2-year follow-up.

Sep 28, 2026

Uploaded by Ben