Total Hip Arthroplasty in a Patient With Contralateral Hemipelvectomy: A Case Report With a One-Year Follow-Up and
Eteesha Rao1, P Nithin Unnikrishnan2
1Surgery, Newcastle University, Newcastle Upon Tyne, GBR.
Abstract:
Total hip arthroplasty (THA) is a standard procedure to alleviate pain and improve joint function in patients with advanced degenerative hip osteoarthritis. Hemipelvectomy, or hindquarter amputation, is a complex, technically demanding procedure with a challenging prosthetic rehabilitation journey. It is often indicated for malignancies or traumatic injury. Hemipelvectomy often leads to a lack of structural stability and altered weight distribution, requiring customized approaches to ensure stability and functional restoration. Thus, THA in patients who have undergone contralateral hemipelvectomy remains a rare procedure, which presents unique surgical and biomechanical challenges, questioning its feasibility in improving the patient's quality of life. This report presents the surgical management and one-year outcomes of a 60-year-old male with a severely osteoarthritic left hip who underwent right-sided hemipelvectomy due to trauma at the age of 18 years, 42 years ago. We then compared our clinical data with other reports in the medical literature, comparing the management approaches with functional outcomes. A literature review was conducted using electronic databases, including PubMed and Google Scholar. Comparisons were drawn with our case to the management approaches with immediate and long-term functional outcomes. A review of the past two decades of literature on THA in similar patients revealed a series of successful procedures with improved long-term mobility. This has been due to significant advancements in surgical positioning, implant technology, and postoperative care, all aimed at optimizing outcomes in this high-risk population. Our findings highlight the feasibility and positive impact of THA in hemipelvectomy patients through a carefully tailored approach with multidisciplinary coordination. While positive outcomes are increasingly achievable, continued research into long-term solutions and adaptive rehabilitation protocols is essential.
