Hip Arthroplasty Case Study

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Revision of bilateral total hip replacement for failed hip arthroplasty after ten years; A case report

Abstract

Key words: Total hip arthroplasty(THA), Extended trochanteric osteotomy(ETO), Revision arthroplasty, Osteolysis,
Introduction
Total hip arthroplasty (THA) is one of the most advanced and common surgical techniques performed in the 20th century of health care system [1-3]. In recent years many patients have been undergoing total hip arthroplasty with a greater success rate of movement with increasing life expectancy and has led to high demands of arthroplasties [4-7]. Since it is a highly successful operation, the expected rate of revision THA surgery can increase in coming years. THA revision is challenging task for the orthopedic
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A patient had history of hypertension for more than five years and nephritis, in which hypertension has been controlled(prevented) with antihypertensive drugs and nephritis treatment was unknown. The patient also had history of surgical procedures which were performed in the bilateral total hip replacement due to femoral head necrosis. Her primary surgery was performed in 2007 at the local hospital due to bilateral femoral head avascular necrosis and was treated with total hip arthroplasty. Six years post-operatively, patient had recurrent symptoms of right hip pain and therefore she underwent for her second surgery on right total hip arthroplasty at the local hospital. Early 2017 she was brought to our hospital outpatient department complaining of bilateral hip pain for one year, on her further investigation we performed lumbar radiography, pelvic radiography, bilateral hip axial radiography that shows: 1. Bilateral Hip Replacement Variations; 2. Pelvic and Bilateral Hip Degeneration; 3. Lumbar Spine Compression; L4-5 Vertebral Body Instability with Intervertebral Space Narrowing; 4. Osteoporosis(Figure 1), for the advance treatment, she was referred to the orthopedic department and was diagnosed of "Bilateral Total Hip arthroplasty and osteoporosis. “A surgeon purposed her for the Bilateral Revision Total Hip arthroplasty. A patient underwent preoperative preparation, that includes blood routine test, urine and stool test, electrocardiograph (ECG), and chest X-ray. Her blood routine such as serum creatinine, liver function tests (LFTs), complete blood count (CBC), C-reactive protein (CRP), calcitonin and interleukin 6 (IL-6) tests, erythrocyte sedimentation ratio (ESR) and coagulation test were all normal. Urine and stool

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