Hip Pelvis.  2013 Mar;25(1):72-76. 10.5371/hp.2013.25.1.72.

Avascular Necrosis of the Femoral Head in a Patient with Poliomyelitis Treated by THA with a Large-diameter Metal Head - A Case Report -

• Yoon TR
• Park KS
• Byun JW
• Kim MC

• KMID: 1425039
• DOI: http://doi.org/10.5371/hp.2013.25.1.72

Abstract

Total hip arthroplasty (THA) can be a good treatment option for avascular necrosis (AVN) of the femoral head. However, because dislocation can frequently occur after surgery, THA is a concern in patients with a neuromuscular disease, such as cerebral palsy or poliomyelitis. In patients with poliomyelitis, only one case of AVN of the femoral head in the affected limb has been reported in the English literature. Here, the authors report on a case of AVN of the femoral head in a patient with poliomyelitis, who was treated with a large diameter femoral head metal-on-metal THA using a modified minimally invasive-2-incision technique.

Keyword

Total hip arthroplasty; Poliomyelitis; Avascular necrosis of the femoral head; Large metal head

MeSH Terms

Arthroplasty
Cerebral Palsy
Dislocations
Extremities
Head
Hip
Humans
Necrosis
Neuromuscular Diseases
Poliomyelitis
Tacrine
Tacrine

Figure

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  Fig. 1 (A, B) Preoperative clinical photograph of the patient walking. He had a left foot deformity, scoliosis with pelvic obliquity, and a Trendelenburg gait.

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  Fig. 2 (A) Preoperative anteroposterior radiograph of both hips showing the crescent sign and sclerotic lesions of the right femoral head. The pelvis was mildly distorted and both proximal femurs were deformed (hip medullary canals were narrow and neck shaft angles were high). (B) Lateral radiograph of the right hip showing the crescent sign on the anterior part of the femoral head.

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  Fig. 3 Plain radiographs taken at two year postoperatively. (A) Both hips anteroposterior and (B) right hip lateral radiographs showing a well bone ingrown acetabular cup and femoral stem. Acetabular abduction and anteversion angles were 57° and 14°, respectively.

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