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Rapid osteolysis after revision hip arthroplasty in Paget's disease
Andrew P Oakley1, John A Matheson
1Department of Orthopaedic Surgery, Dunedin Hospital, Dunedin, New Zealand.
Insights
Paget
Area of Science:
- Orthopedic Surgery
- Bone Metabolism
Background:
- Paget's disease of bone is characterized by increased bone turnover.
- Total hip arthroplasty (THA) is a common procedure for hip conditions.
Observation:
- A 71-year-old man with Paget's disease underwent revision THA for a femoral component fracture.
- Postoperatively, he developed rapid osteolysis distal to the fracture site.
Findings:
- Paget's disease activity can lead to severe osteolysis after hip arthroplasty.
- This complication occurred despite successful fracture management.
Implications:
- Surgeons must consider Paget's disease activity in patients undergoing hip arthroplasty.
- Awareness of potential osteolysis is crucial for managing these complex cases.
Abstract:
Rapid bone turnover in Paget's disease has been of concern to many surgeons performing hip arthroplasties. We present the case of a 71-year-old man with Paget's disease affecting the proximal femur. He had undergone total hip arthroplasty 14 years before. He sustained a fracture at the tip of the femoral component, which was managed with revision total hip arthroplasty. His postoperative course was complicated by rapid and profound osteolysis of the femur distal to the fracture site, secondary to disease activity. This case highlights the need for awareness of Paget's disease activity and this potential complication.