A case report of severely damaged hip joint caused by SAPHO syndrome treated with 2-stage total hip arthroplasty

Abstract

Introduction:Synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome is an increasingly recognized entity. The hip joint is known as a less frequently affected site in SAPHO syndrome, and there has been limited reports about hip joint diseases caused by SAPHO syndrome, and as such adequate treatment for this disease spectrum is still not fully elucidated.Case:We describe the case of a 52-year-old man admitted for SAPHO syndrome who went on to be diagnosed with advanced secondary hip arthritis associated with disabling right hip pain. The diagnosis of SAPHO syndrome was delayed; the patient was given a clinical diagnosis of osteomyelitis and treated with prolonged courses of antibiotics and open surgical debridement at previous tertiary health facility. The patient underwent 2-stage joint replacement surgery in our hospital. At 1 year after the surgery, he is well, with minimal right hip pain and the prosthesis is functioning well.Conclusion:This case shows the safety and effectiveness of the 2-stage joint replacement in treating destructive hip disease caused by SAPHO syndrome mimicking infectious arthritis.

Clinical and imaging features of six Han patients with SAPHO syndrome

“…Severe synovitis is resistant to any conservative treatment, and arthroscopic synovectomy is a good choice for refractory knee synovitis (49). In addition, for advanced hip injury with severe pain and significantly limited activity, total hip arthroplasty can also achieve significant results (50). Although people's awareness of SAPHO syndrome has increased, and the disease is gradually becoming known to rheumatologists and dermatologists, it is still rarely reported in orthopedics or surgical literature.…”

SAPHO syndrome with a pathological fracture of clavicle: a case report

“…Cheng et al(16) used percutaneous vertebroplasty for SAPHO syndrome with vertebral destruction, where the heat generated during PVP can destroy in ammatory factors. Yeo et al(17) also thoroughly removed the in amed tissue during a total hip replacement in patients with SAPHO syndrome.As an independent case, it can enrich our knowledge about SAPHO syndrome, especially in terms of treatment. Internal xation operation met our expectations but more cases are needed to support its safety and e cacy.…”