An algorithmic approach to total hip arthroplasty in patient with post-polio paralysis and fixed pelvic obliquity
Autor: | Krishna Kiran Eachempati, Saurabh Gupta, Deepak Gautam, Rajesh Malhotra |
---|---|
Rok vydání: | 2021 |
Předmět: |
musculoskeletal diseases
Hip arthritis medicine.medical_specialty Radiography Total hip arthroplasty (THA) soft tissue contractures paralysis pelvis Post-polio paralysis Arthroplasty hips Soft-tissue contracture Paralysis medicine In patient Pelvic obliquity Pelvis Orthopedic surgery Hip business.industry General Engineering Soft tissue Reverse Hybrid Contracture release Gait Surgery medicine.anatomical_structure Total hip arthroplasty subtrochanteric shortening pelvic obliquity Radiographs medicine.symptom business RD701-811 soft tissues |
Zdroj: | Bone & Joint Open Bone & Joint Open, Vol 2, Iss 9, Pp 696-704 (2021) |
ISSN: | 2633-1462 |
Popis: | Aims Total hip arthroplasty (THA) in patients with post-polio residual paralysis (PPRP) is challenging. Despite relief in pain after THA, pre-existing muscle imbalance and altered gait may cause persistence of difficulty in walking. The associated soft tissue contractures not only imbalances the pelvis, but also poses the risk of dislocation, accelerated polyethylene liner wear, and early loosening. Methods In all, ten hips in ten patients with PPRP with fixed pelvic obliquity who underwent THA as per an algorithmic approach in two centres from January 2014 to March 2018 were followed-up for a minimum of two years (2 to 6). All patients required one or more additional soft tissue procedures in a pre-determined sequence to correct the pelvic obliquity. All were invited for the latest clinical and radiological assessment. Results The mean Harris Hip Score at the latest follow-up was 79.2 (68 to 90). There was significant improvement in the coronal pelvic obliquity from 16.6o (SD 7.9o) to 1.8o (SD 2.4o; p < 0.001). Radiographs of all ten hips showed stable prostheses with no signs of loosening or migration, regardless of whether paralytic or non-paralytic hip was replaced. No complications, including dislocation or infection related to the surgery, were observed in any patient. The subtrochanteric shortening osteotomy done in two patients had united by nine months. Conclusion Simultaneous correction of soft tissue contractures is necessary for obtaining a stable hip with balanced pelvis while treating hip arthritis by THA in patients with PPRP and fixed pelvic obliquity. Cite this article: Bone Jt Open 2021;2(9):696–704. |
Databáze: | OpenAIRE |
Externí odkaz: |