Hip arthoplasty in a forester after numerous tick bites

Area of Science:

• Infectious Diseases
• Orthopedic Surgery
• Neurology

Background:

• Lyme disease, caused by Borrelia burgdorferi, frequently presents with arthritis in its late stages.
• Neuroborreliosis, a neurological manifestation of Lyme disease, can involve spinal nerve compression.
• Orthopedic complications, such as hip joint destruction, are less common but significant in Lyme disease.

Observation:

• A forester with a history of treated Lyme disease and suspected neuroborreliosis underwent hip replacement arthroplasty.
• Previous imaging revealed spinal disc herniations compressing L4 and L5 nerve roots.
• The patient developed significant hip joint destruction necessitating surgical intervention.

Findings:

• The case highlights a potential link between past neuroborreliosis and subsequent hip joint pathology.
• Arthritis in Lyme disease can progress to severe joint destruction requiring orthopedic procedures.
• Ceftriaxone treatment was administered for suspected neuroborreliosis 12 years prior to hip replacement.

Implications:

• Neuroborreliosis may play an active role in the pathogenesis of Lyme-related hip joint destruction.
• This case underscores the importance of considering Lyme disease in patients with unexplained joint pathology.
• Further research is warranted to elucidate the mechanisms linking neuroborreliosis and orthopedic manifestations.