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Results of total hip arthroplasty in Gaucher's disease patients
1Department of Trauma and Orthopaedics and Orthopaedic Research Unit, Addenbrooke's Hospital, Cambrid. vijaysuma3@yahoo.co.uk
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Total hip arthroplasty (THA) in Gaucher
Area of Science:
- Orthopedic Surgery
- Rheumatology
- Genetics
Background:
- Gaucher's disease is a lysosomal storage disorder.
- Patients with Gaucher's disease may develop avascular necrosis of the femoral head.
- Avascular necrosis can lead to hip pain and dysfunction, necessitating total hip arthroplasty (THA).
Purpose of the Study:
- To evaluate the success and complications of total hip arthroplasty (THA) in patients with Gaucher's disease.
- To analyze revision rates and reasons for revision in this patient population.
Main Methods:
- Retrospective study of nine total hip replacements in six patients with Gaucher's disease.
- Data collected included patient demographics, primary THA details, revision surgeries, and follow-up duration.
- Complications such as infection, blood loss, and implant loosening were recorded.
Main Results:
- Five out of nine hips (55.6%) required revision surgery for loosened implants.
- One hip underwent two revision surgeries.
- The average age at primary THA was 35.3 years.
- Average time to first revision was 11.4 years.
- Superficial infection occurred in one patient; excessive blood loss in three.
Conclusions:
- Total hip arthroplasty in Gaucher's disease patients has a high revision rate due to implant loosening.
- THA success in this population is controversial and requires careful consideration.
- Further research is needed to optimize surgical outcomes for Gaucher's patients undergoing THA.
Abstract:
There is controversy regarding the success of total hip arthroplasty (THA) in patients with Gaucher's disease. We present a retrospective study of nine total hip replacements in six patients (four primary THAs and five revisions). Four were female and two were male. All patients were of white ethnic origin. Five hips have required revision surgery for loosened implants (four once only and one twice). The average age at the time of primary THA was 35.3 years (13-54). The average duration between primary THA and first revision was 11.4 years (6-19). The duration between first and second revision in one hip was six years. The follow-up ranged between 2.5 years to 19 years. One patient developed superficial infection postoperatively which settled with wound debridement and antibiotics. Excessive peri-operative blood loss was noted in three patients.