Rapidly destructive hip disease causative factors: A case report and literature review

It is a rare disease with an unknown etiology and unclear mechanisms, characterized by rapid progression and severe bone destruction, which often leads to late clinical diagnosis and treatment. This study reviewed the literature related to cases of rapid destructive hip disease and the potential causative factors of the disease to offer insights for further diagnosis and treatment.

A 45-year-old female patient with a history of syphilis initially underwent a total knee arthroplasty due to ineffective conservative management of degenerative left knee disease. Eight months after surgery, the patient developed pain and limited mobility in the ipsilateral hip.

Imaging examinations, including radiography, 3-dimensional computed tomography (3D CT), and nuclear magnetic resonance imaging, revealed osteolytic destruction of the femoral head and neck.

This condition was initially suspected to be a rapidly destructive hip disease, which was treated with left total hip arthroplasty, and was confirmed to be a rapidly destructive hip disease by postoperative pathology.

Postoperative pathology confirmed a diagnosis of rapidly destructive hip disease. The patient recovered well after the surgery, demonstrating good function in both hip and knee joint activities. However, at a later follow-up visit, it was learned that the patient had 4 posterior dislocations. Upon closer examination, the causes were all due to unintentional postures or maneuvers that induced the dislocations.

When rapid destructive hip disease is suspected, prompt and thorough evaluation is required. Once diagnosed, total hip arthroplasty should be performed as soon as possible to minimize the risk of postoperative complications such as dislocation, loosening, and infection. In the postoperative period, you should avoid movements that may cause dislocation, such as bending over, crossing your legs, sitting on a low stool, etc.