Hip replacement in a Charcot joint: a case report and historical review

A 61-year-old woman with a neuropathic joint was treated by total hip arthroplasty. Histologically, the absence of any osseous repair process in this hip is consistent with reports that neuropathic fractures of the femoral neck generally fail to unite. The fragments of necrotic bone found in the synovium are characteristic of the pathologic process. The above-described patient is typical of the preataxic stage. The seven-year successful result of total hip arthroplasty is most likely explained by the fact that the patient was not ataxic. Because of the unpredictability of neurosyphilis, seven years should not be considered the touchstone of success. From this experience there is no recommendation or even a suggestion that hip arthroplasty should be performed on ataxic patients.