Bilateral total hip replacement in arthrogryposis multiplex congenita

Area of Science:

• Orthopedic Surgery
• Rheumatology

Background:

• Arthrogryposis multiplex congenita (AMC) presents unique challenges for surgical interventions, including total hip replacement (THR).
• Perioperative management requires careful consideration of patient-specific factors such as limited mouth opening and joint contractures.

Observation:

• A 56-year-old patient with AMC underwent bilateral THRs using a standard posterior approach.
• Preoperative planning addressed anesthetic risks (e.g., fiberoptic intubation) and perioperative positioning challenges.
• Meticulous soft tissue balancing was performed to mitigate dislocation risk.

Findings:

• The patient experienced no perioperative complications.
• Postoperative outcomes included significant improvement in pain and hip function scores.
• Objective range of motion (ROM) did not improve, and the patient did not return to work.

Implications:

• Total hip replacement (THR) is a viable treatment for osteoarthritic hip pain in AMC patients.
• Informed consent should include the expectation of limited improvement in range of motion (ROM).
• Further research may explore strategies to enhance functional ROM post-THR in AMC patients.