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Pituitary apoplexy after joint arthroplasty
Vivek Goel1, Ujjwal K Debnath, Jagmohan Singh
1Department of Trauma and Orthopaedics, Royal Gwent Hospital, Newport, United Kingdom.
The Journal of Arthroplasty
|October 25, 2008
Summary
Pituitary apoplexy, a rare condition, can occur after surgery. This report details two cases following hip and knee replacements, highlighting a previously undocumented link to hip arthroplasty.
Area of Science:
- Endocrinology
- Neurosurgery
- Orthopedic Surgery
Background:
- Pituitary apoplexy is a rare, life-threatening endocrine emergency.
- It results from sudden pituitary adenoma enlargement due to infarction or hemorrhage.
- Symptoms include severe headache, vision loss, and altered consciousness.
Observation:
- Two patients developed pituitary apoplexy postoperatively.
- The cases occurred after total hip and total knee arthroplasty.
- This is the first reported instance following total hip arthroplasty.
Findings:
- Asymptomatic pituitary adenomas pose diagnostic challenges preoperatively.
- Postoperative pituitary apoplexy can manifest unexpectedly after major orthopedic surgery.
- The study identifies a novel association between total hip arthroplasty and pituitary apoplexy.
Implications:
- Highlights the importance of considering pituitary apoplexy in patients with unexplained neurological symptoms post-arthroplasty.
- Suggests potential screening or awareness for pituitary adenomas in patients undergoing major orthopedic procedures.
- Underscores the need for further research into the triggers and management of postoperative pituitary apoplexy.
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