Camacho-Galindo J, Soria-Bastida MA, Torres-Higuita JK, Ilizaliturri-Sánchez VM

Language: Spanish
References: 5
Page: 60-63
PDF size: 184.26 Kb.

ABSTRACT

Introduction: Associated neurological disorders pose a challenge hip joint reconstruction. The imbalance and poor muscle tone predispose to dislocation and loosening of the prosthesis.
Clinical case: The following is the case of a 67 years old patient with a hemorrhagic cerebral vascular event with a secondary left hemiparesis. Ten years later had a femoral neck fracture on the affected side. Initially she was treated with conservative management resulting in pain and discapacity, valued with WOMAC scale in 12 points. Two years later was treated with total hip arthroplasty with large diameter femoral head. We present the follow up of 41 months, asymptomatic, walking using a cane and a WOMAC score of 41, with no signs of radiological loosening or dislocation.
Conclusions: There is no experience documented in neurological disorders associated with hip diseases that requires a total hip arthroplasty. Loosening of the implants, dislocation and heterotopic ossification has been described as complications of the procedure. Large heads in total hip arthroplasty and a correct surgical technique associated with a multidisciplinary management in patients with neurological disorders offers an opportunity as a treatment in patient with hip disorders.

REFERENCES

1. Queally JM, Abdulkarim A, Mulhall KJ. Total hip replacement in patients with neurological conditions. J Bone Joint Surg [Br] 2009;91-B(10):1267-1273.

2. Cabanela ME. Weber M. Total hip arthroplasty in patients with neuromuscular disease. Instr Course Lect 2000;49:163-168.

3. Meek RM, Allan DB, McPhillips G, Kerr L, Howie CR. Epidemiology of Dislocation after Total Hip Arthroplasty. Clin Orthop Relat Res 2006;447:9-18.

4. DiCaprio MR, Huo MH, Zatorski LE, Keggi K. Incidence of heterotopic ossification following total hip arthroplasty in patients with prior stroke. Orthopedics 2004;27(1):41-43.

5. Woolson ST, Rahimtoola ZO. Risk factors for dislocation during the first 3 months after primary total hip replacement. J Arthroplasty 1999;14(6):662-668.