Long-term Outcome of Unconstrained Primary Total Hip Arthroplasty in Ipsilateral Residual Poliomyelitis

Abstract

Incapacitating articular sequelae in the hip joint have been described for patients with late effects of poliomyelitis. In these patients, total hip arthroplasty (THA) has been associated with a substantial rate of dislocation. This study was conducted to evaluate the long-term clinical and radiologic outcomes of unconstrained THA in this specific group of patients. The study included 6 patients with ipsilateral polio who underwent primary THA between 1985 and 2006. Patients with polio who underwent THA on the nonparalytic limb were excluded. Mean follow-up was 119.5 months (minimum, 84 months). Clinical outcomes were evaluated with the modified Harris Hip Score (mHHS) and the visual analog scale (VAS) pain score. Radiographs were examined to identify the cause of complications and determine the need for revision surgery. All patients showed significantly better functional results when preoperative and postoperative mHHS (67.58 vs 87.33, respectively; P=.002) and VAS pain score (7.66 vs 2, respectively; P=.0003) were compared. Although 2 cases of instability were diagnosed, only 1 patient needed acetabular revision as a result of component malpositioning. None of the patients had component loosening, osteolysis, or infection. Unconstrained THA in the affected limb of patients with poliomyelitis showed favorable long-term clinical results, with improved function and pain relief. Nevertheless, instability may be a more frequent complication in this group of patients compared with the general population. [Orthopedics. 2017; 40(2):e255-e261.].

Total Hip Arthroplasty in Patients With Neurological Conditions: A Systematic Review

“…Their component revision rate at 6-year follow-up was 5.1%, with osteolysis (10.2%) and dislocation (5.1%) being the most commonly encountered complications. A further 8 retrospective case series with a total of 78 THAs also reported improved functional outcomes through a variety of scoring systems, [ [56] , [57] , [58] , [59] , [61] , [62] , [63] , [64] ] which are detailed in Figure 5 .

Figure 5 Total hip arthroplasty in poliomyelitis results.

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Systematic Review of Total Hip Arthroplasty Outcomes in Cerebral Palsy Patients and a Comparative Analysis with Rheumatoid Arthritis

“…Given that instability/dislocation remains one of the most common complications of THA, some authors have suggested that constrained liners (CL) may be associated with higher loosening rates in the long term [35]. However, Ryu et al have shown that both CL and dual-mobility (DM) liners efectively reduce the risk of hip dislocation in elderly patients with neuromuscular diseases, including CP [36].…”

Correlation Between Harris, Modified Harris Hip, Oxford Hip Scores of Patients Who Underwent Hip Arthroplasty and Hemiarthroplasty Following Hip Fracture

“…[ 16 ] Edwards et al[ 18 ] suggested that using MHSS instead of HHS is adequate for determining functional outcomes after primary and revision THA. Recent studies related to primary or revision THA have reported their results with MHHS,[ 23 , 24 ] which appears to be more practical than HHS and may help save the surgeon’s time in an outpatient clinic. In the present study, there was a very strong correlation between HHS and MHHS in both, primary and revision THA.…”