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Total hip arthroplasty after contralateral hip disarticulation: a challenging "simple primary"
Colin G Murphy1, Michel P Bonnin, Tarik Aїt Si Selmi
1Centre Orthopedique Santy, Lyon, France. cmurphy@rcsi.ie.
Summary
Total hip arthroplasty can treat severe hip arthritis in patients with a history of hip disarticulation. This case highlights complex surgical considerations for successful outcomes in unique patient populations.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
Background:
- Lower limb amputation, particularly hip disarticulation, often leads to hip and knee osteoarthritis in residual and contralateral limbs.
- Existing prosthetics show poor compliance, increasing reliance on the sound limb and potentially exacerbating joint degeneration.
Observation:
- A 51-year-old female, post-right hip disarticulation 25 years prior and using crutches, presented with severe left hip arthritis.
- The patient's condition necessitated total hip arthroplasty, presenting a unique surgical challenge due to the absence of a contralateral hip joint.
Findings:
- The study details the complex technical aspects of performing total hip arthroplasty in a patient with a history of hip disarticulation.
- Key considerations included meticulous prosthesis selection, appropriate bearing surface choice, and precise preoperative and intraoperative management of limb length and offset.
Implications:
- This case underscores the feasibility and challenges of total hip arthroplasty in patients with hip disarticulation, offering a potential solution for debilitating arthritis.
- Successful management requires specialized surgical planning and execution to address biomechanical complexities and optimize functional recovery.
