Total Hip Arthroplasty in Patients who had Previous Infection of the Hip with LegLength Discrepancy.
10.4055/jkoa.2006.41.2.189
- Author:
Joong Myung LEE
1
;
Churl Woo LEE
;
Won Joon WANG
;
Hyo Chul TAK
Author Information
1. Department of Orthopedic Surgery, National Medical Center, Seoul, Korea. drjmlee@paran.com
- Publication Type:Original Article
- Keywords:
Total hip arthroplasty;
Sequelae infectious arthritis;
Limb length discrepancy
- MeSH:
Amputation;
Arthroplasty, Replacement, Hip*;
Extremities;
Femoral Artery;
Femoral Nerve;
Follow-Up Studies;
Gait;
Hip*;
Humans;
Incidence;
Leg;
Paralysis;
Patient Satisfaction;
Postoperative Complications;
Recurrence;
Sciatic Nerve;
Tuberculosis
- From:The Journal of the Korean Orthopaedic Association
2006;41(2):189-196
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: To analyze the results of a minimum of three-year follow-up in patients with a severely deformed sequelae pyogenic hip, who had undergone total hip arthroplasty with a simultaneous limb length correction. MATERIALS AND METHODS: The postoperative complication, clinical and the radiographic results were analyzed in 74 out of 102 patients, who were followed for a minimum of three years between December 1987 and May 2003. The average age was 42.8 years. The average follow-up duration was 4 years and 11 months. There were 50 tuberculosis infections, 24 pyogenic infections, and 23 fused hip cases. The average leg length shortening was 4.1 cm (range, 1.0-10.0 cm). RESULTS: Preoperative Harris hip score improved to 90.2 postoperatively from 65.0 (range, 25-92.5) preoperatively. Leg length shortening was corrected by 0.4 cm (0.0-3.0 cm). Radiographically, excluding the 3 revisions, no case met the criteria of definite loosening. The postoperative complications included the recurrence of tuberculosis (2 cases), and variable nerve palsies, including femoral nerve (3 cases), and a sciatic nerve (3 cases). These patients completely recovered from nerve palsy. B-K amputation, after the postoperative exacerbation of circulation to the affected limb, was needed in one case with a preoperatively undetected femoral artery occlusion. CONCLUSION: Although, restoring the normal limb length in the severely deformed pyogenic hip sequelae patients requires highly demanding surgical techniques, with a relatively higher incidence of postoperative complications, it is possible to achieve a higher level of patient satisfaction and definite gait improvement.
