The Natural History of the Development of Trevor Disease of the Hip and Subsequent Arthroplasty: A Case Report

JBJS Case Connect. 2017 Jul-Sep;7(3):e67. doi: 10.2106/JBJS.CC.16.00277.

Abstract

Case: Trevor disease (dysplasia epiphysealis hemimelica [DEH]) is a rare, intra-articular anomaly of cartilaginous overgrowth of the epiphysis. The usual presentation is on 1 side of the body and on 1 side of the epiphysis. The natural history of this disease is not clear because the lesions often are treated during childhood. Additionally, hip involvement is relatively uncommon; to our knowledge, total hip arthroplasty in a patient with DEH has not been reported previously. Our patient presented with previously untreated DEH of the hip joint, which had developed into a very unusual shape. He was treated with a total hip arthroplasty and had satisfactory functioning 2.5 years postsurgery.

Conclusion: Untreated DEH of the hip can lead to a very misshapen hip with a deformed femoral head and loss of the shape of the acetabulum, as well as stiffness due to an unusual shape and osteoarthritic changes. A total hip arthroplasty can give satisfactory functional results.

Publication types

  • Case Reports

MeSH terms

  • Acetabulum / abnormalities*
  • Acetabulum / pathology
  • Acetabulum / surgery
  • Adult
  • Arthroplasty / methods*
  • Bone Diseases, Developmental / diagnosis*
  • Bone Diseases, Developmental / surgery
  • Epiphyses / abnormalities*
  • Epiphyses / pathology
  • Epiphyses / surgery
  • Femur / abnormalities*
  • Femur / surgery
  • Hip / diagnostic imaging
  • Hip / pathology*
  • Humans
  • Intraoperative Period
  • Leg Length Inequality / diagnosis*
  • Leg Length Inequality / surgery
  • Male
  • Radiography / methods
  • Tibia / abnormalities*
  • Tibia / surgery
  • Treatment Outcome

Supplementary concepts

  • Dysplasia epiphysealis hemimelica