[Translated article] Primary total hip arthroplasty in patients with sequelae of poliomyelitis

P Rodríguez-Zamorano; J Otero Otero; A Pérez González; L E Moro Rodríguez; F Marco

doi:10.1016/j.recot.2023.06.007

[Translated article] Primary total hip arthroplasty in patients with sequelae of poliomyelitis

Rev Esp Cir Ortop Traumatol. 2023 Sep-Oct;67(5):T401-T410. doi: 10.1016/j.recot.2023.06.007. Epub 2023 Jun 14.

[Article in English, Spanish]

Authors

P Rodríguez-Zamorano¹, J Otero Otero², A Pérez González², L E Moro Rodríguez², F Marco³

Affiliations

¹ Departamento de Cirugía Ortopédica y Traumatología, Hospital Clínico San Carlos, Madrid, Spain. Electronic address: patri_newyork@yahoo.es.
² Departamento de Cirugía Ortopédica y Traumatología, Hospital Clínico San Carlos, Madrid, Spain.
³ Departamento de Cirugía Ortopédica y Traumatología, Hospital Clínico San Carlos, Madrid, Spain; Departamento de Cirugía, Universidad Complutense de Madrid, Madrid, Spain.

PMID: 37328055
DOI: 10.1016/j.recot.2023.06.007

Abstract

Introduction: Total hip arthroplasty (THA) in patients with residual poliomyelitis (RP) is a surgical challenge. Dysplastic morphology, osteoporosis and gluteal weakness hinder orientation, increase fracture risk and reduce implant stability. The aim of this study is to describe a series of patients with RP treated by THA.

Material and methods: Retrospective descriptive study of patients with RP treated with THA between 1999 and 2021 in a tertiary hospital, with clinical and radiological follow-up and functional and complication evaluation until present or death, with a minimum of 12 months.

Results: Sixteen patients underwent surgery, with 13 THA implanted in the paretic limb, 6 for fracture and 7 for osteoarthritis, while the remaining 3 were implanted in the contralateral limb. Four dual mobility cups were implanted as an antiluxation measure. At 1 year postoperatively, 11 had complete range of motion with no increase in Trendelenburg cases. The Harris hip score (HHS) improved 32.1 points, the visual analogue scale (VAS) 5.25 points, and the Merlé-d'Augbiné-Poste scale 6 points. The length discrepancy correction was 13.77mm. Median follow-up was 3.5 years (1-24). Two cases were revised for polyethylene wear and two for instability, with no infections, periprosthetic fractures, or cup or stem loosening.

Conclusions: THA in patients with RP allows improvement of the clinico-functional situation with an acceptable complication rate. The risk of dislocation could be minimised with dual mobility cups.

Keywords: Artroplastia total de cadera; Coxarthrosis; Coxartrosis; Dislocation; Displasia; Dysplasia; Luxación; Miembro parético; Paretic limb; Poliomielitis; Poliomyelitis; Total hip arthroplasty.