J Korean Orthop Assoc.  1981 Dec;16(4):927-936. 10.4055/jkoa.1981.16.4.927.

Total Hip Arthroplasty on Paralytic Hips: Two Case Report on Poliomyelitic and Cerebral Palsied Hips

• Lee DY
• Song HS
• Chang JS

• KMID: 2450734
• DOI: http://doi.org/10.4055/jkoa.1981.16.4.927

Abstract

We performed total hip arthroplasty on a young male adult with paralytic dislocation of the hip due to poliomyelitis. Because of extreme shortening, as well as instability and weakness, the patient was unable to bear weight on the limb. Pastoperative course was complicated by ectopic ossification that compromised the hip and knee motion. Another young male adult with severe spastic cerebral palsy underwent total hip arthroplasty because of an intractable pain due to degenerative arthritis. Initial attempt coupled with adductor tenotomy and obtuator neurectomy ended in gross loosening and acetabular protrusion. Revision consisted of extensive soft tissue release and bone grafting of acetabular defect and use of a protrusion cup and an extra-long stem. Postoperative course was complicated by long-standing serous aseptic discharge from the wound which was controlled by antibiotics and prolonged recumbency. Indications for total hip arthroplasty in paralytic hips are rare and should be reserved for the most crippling conditions and one must be prepared fvr technical difficulties and a variety of complications with a prospecs for less than optimum results.

Keyword

Paralytic hip; Total hip arthroplasty

MeSH Terms

Acetabulum
Adult
Anti-Bacterial Agents
Arthroplasty, Replacement, Hip*
Bone Transplantation
Cerebral Palsy
Dislocations
Extremities
Hip*
Humans
Knee
Male
Ossification, Heterotopic
Osteoarthritis
Pain, Intractable
Poliomyelitis
Spectinomycin
Tenotomy
Wounds and Injuries
Anti-Bacterial Agents
Spectinomycin