Total Hip Arthroplasty Using a Polished Tapered Cemented Stem in Hereditary Multiple Exostosis

Area of Science:

• Orthopedic Surgery
• Medical Imaging
• Genetics

Background:

• Hereditary multiple exostosis can cause significant hip joint pain (coxalgia) and deformities.
• Radiographic findings include enlarged femoral head, increased shaft angle, and widened femoral neck.
• Coxarthrosis and severe hip pain are common complications, complicating standard prosthetic joint replacement.

Purpose of the Study:

• To describe the surgical management of a patient with hereditary multiple exostosis presenting with severe hip pain and coxarthrosis.
• To evaluate the efficacy of a cemented polished tapered stem in total hip arthroplasty for complex femoral bone deformities.
• To assess the impact of this surgical approach on invasiveness and bone defect management.

Main Methods:

• A 61-year-old Japanese male with hereditary multiple exostosis underwent right total hip arthroplasty.
• A direct lateral approach was utilized for the surgical procedure.
• A cemented polished tapered stem was selected due to significant proximal femur bone transformation and defects.

Main Results:

• The cemented polished tapered stem effectively accommodated the transformed femoral bone structure.
• Bone substance defects resulting from exostosis were successfully managed.
• The surgical approach minimized invasiveness despite the complex bone morphology.

Conclusions:

• Total hip arthroplasty with a cemented polished tapered stem is a viable option for hereditary multiple exostosis with severe hip joint pathology.
• This technique offers a solution for challenging femoral bone anatomy, improving patient outcomes.
• The chosen method balances effective treatment of bone deformities with reduced surgical impact.